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放射性碘残留消融术后甲状腺癌患者唾液腺功能的闪烁显像评估

Scintigraphic evaluation of salivary gland function in thyroid cancer patients after radioiodine remnant ablation.

作者信息

Krčálová Eva, Horáček Jiří, Gabalec Filip, Žák Pavel, Doležal Jiří

机构信息

Nuclear Medicine Department, University Hospital Hradec Králové, Hradec Králové, Czech Republic.

Academic Department of Internal Medicine, Faculty of Medicine in Hradec Králové, Charles University, Hradec Králové, Czech Republic.

出版信息

Eur J Oral Sci. 2020 Jun;128(3):204-210. doi: 10.1111/eos.12689. Epub 2020 Apr 2.

Abstract

Radioiodine ( I, RAI) has traditionally been used in thyroid cancer treatment but its benefit should be balanced against possible risks. Among them, salivary gland dysfunction has often been discussed, although the reported data have been inconsistent. The aim of our prospective study was to evaluate salivary gland function in 31 thyroidectomised patients (6 men, 25 women; median age 52 yr) before and 4-6 months after RAI remnant ablation (RRA), using activity of 3.7 GBq I-NaI. Salivary gland uptake and excretion fractions were quantitatively assessed with Tc - pertechnetate salivary gland scintigraphy. Pre- and post-treatment values were compared using Wilcoxon signed rank test. No statistically significant difference in the pre- and post-treatment values was observed in parotid or submandibular glands uptake, or in the parotid or submandibular excretion fractions. The calculated power for minimum relevant difference of 25% with the sample size of 31 ranged between 86% and 96% for the individual variables, making our negative results reasonably reliable. The results suggest that RRA with the most commonly used activity of 3.7 GBq has no important impact on salivary gland function. Therefore, the concerns about putative salivary gland functional deterioration following RRA are probably unjustified.

摘要

放射性碘(I,RAI)传统上用于甲状腺癌治疗,但其益处应与潜在风险相权衡。其中,涎腺功能障碍常被讨论,尽管报告的数据并不一致。我们前瞻性研究的目的是,使用3.7GBq I-NaI的活度,评估31例甲状腺切除患者(6例男性,25例女性;中位年龄52岁)在RAI残余甲状腺组织消融(RRA)前及4 - 6个月后的涎腺功能。用高锝酸盐唾液腺闪烁显像法定量评估唾液腺摄取和排泄分数。采用Wilcoxon符号秩检验比较治疗前后的值。在腮腺或颌下腺摄取,或腮腺或颌下腺排泄分数方面,未观察到治疗前后值有统计学显著差异。对于样本量为31且最小相关差异为25%的情况,各变量的计算效能在86%至96%之间,这使得我们的阴性结果相当可靠。结果表明,采用最常用的3.7GBq活度进行RRA对涎腺功能没有重要影响。因此,对RRA后假定的涎腺功能恶化的担忧可能是没有道理的。

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