He Ying, Pan Ming-Zhi, Huang Jian-Min, Xie Peng, Zhang Fang, Wei Ling-Ge
Department of Ultrasound , West China Hospital, Sichuang University, Chengdu, Sichuan, China (mainland).
Department of Nuclear Medicine, West China Hospital, Sichuang University, Chengdu, Sichuan, China (mainland).
Med Sci Monit. 2016 Dec 15;22:4924-4928. doi: 10.12659/msm.899028.
BACKGROUND The aim of this study was to assess the efficacy of radioactive iodine-131 (¹³¹I) therapy for lymph node metastasis of differentiated thyroid cancer (DTC) and to identify influential factors using univariate and multivariate analyses to determine if identified factors influence the efficacy of treatment. MATERIAL AND METHODS This study included a retrospective review of 218 patients with histologically proven DTC in the post-operation stage. After thyroid tissue remnants were eliminated with ¹³¹I therapy, patients' lymph node status was confirmed by ultrasound and by ¹³¹I whole body scan regarding lymph node metastasis, and then patients were treated with ¹³¹I as appropriate. The treatment efficacy was assessed and possible influencing factors were identified using univariate and multivariate analyses. RESULTS The total effective rate of ¹³¹I therapy was 88.07% (including a cure rate of 20.64% and an improvement rate of 67.43%). The non-effective rate was 11.93%. Of the total 406 lymph nodes of 218 patients, 319 lymph nodes (78.57%) were judged to be effectively cured, including 133 (32.75%) lymph nodes that were totally eliminated and 186 (45.82%) lymph nodes that shrank. Eighty-seven (21.43%) of the 406 lymph nodes had no obvious change. No lymph nodes were found to be in a continuously enlarging state. Distant metastasis, size of lymph node, human serum thyroglobulin (HTG) level, and condition of thyroid remnants ablation were identified as the independent factors influencing the efficacy of treatment using univariate and multivariate analyses. CONCLUSIONS The use of ¹³¹I is a promising treatment for lymph node metastasis of DCT. Distant metastasis, size of lymph nodes, HTG level, and condition of thyroid remnant ablation were independent factors influencing the treatment efficacy.
背景 本研究旨在评估放射性碘 - 131（¹³¹I）治疗分化型甲状腺癌（DTC）淋巴结转移的疗效，并通过单因素和多因素分析确定影响因素，以判断所确定的因素是否影响治疗效果。
材料与方法 本研究对218例术后经组织学证实为DTC的患者进行回顾性分析。在用¹³¹I治疗消除甲状腺组织残余后，通过超声和¹³¹I全身扫描确认患者的淋巴结状态以判断淋巴结转移情况，然后对患者进行适当的¹³¹I治疗。采用单因素和多因素分析评估治疗效果并确定可能的影响因素。
结果 ¹³¹I治疗总有效率为88.07%（其中治愈率为20.64%，改善率为67.43%）。无效率为11.93%。218例患者共406个淋巴结中，319个淋巴结（78.57%）被判定有效治愈，其中133个淋巴结（32.75%）完全消除，186个淋巴结（45.82%）缩小。406个淋巴结中有87个（21.43%）无明显变化。未发现淋巴结处于持续增大状态。通过单因素和多因素分析确定远处转移、淋巴结大小、人血清甲状腺球蛋白（HTG）水平以及甲状腺残余消融情况为影响治疗效果的独立因素。
结论 ¹³¹I治疗DCT淋巴结转移是一种有前景的治疗方法。远处转移、淋巴结大小、HTG水平以及甲状腺残余消融情况是影响治疗效果的独立因素。
