Department of Nuclear Medicine, West China Hospital of Sichuan University, No. 37. Guoxue Alley, 610041 Chengdu, Sichuan province, P.R. China.
Hell J Nucl Med. 2021 Jan-Apr;24(1):53-59. doi: 10.1967/s002449912306. Epub 2021 Apr 20.
The aim of this study was to determine prognostic value of radioactive iodine uptake (RAIU) and stimulated thyroglobulin (sTg) regarding the ablation efficacy in patients with differentiated thyroid cancer.
We studied 466 differentiated thyroid cancer (DTC) patients without distant metastases after thyroidectomy who underwent iodine-131 (I) ablation and were pre-therapy assessed by RAIU. The patients were divided into four groups according to the RAIU result, including: A) RAIU<2%, B) 2%≤RAIU<5%, C) 5%≤RAIU<10% and D) RAIU≥10%. Every group was divided into four subgroups according to sTg levels, namely: 1) sTg<2ng/mL, 2) 2ng/mL≤sTg<5ng/mL, 3) 5ng/mL≤sTg<10ng/mL and 4) sTg≥10ng/mL subgroup. The ablation success was defined as a negative scan 6 months to 1 year and other imaging like US did not detect anything suspicious after ablation. Excellent response was considered as: sTg<1ng/mL with negative thyroglobulin antibodies (TgAb) and negative image scans.
The rate of successful ablation was 88.3%, 88.7%, 88.4% and 79% between group A to D, respectively (P=0.779). There was also no significant difference about the excellent response rate (64.5% vs 63.6% vs 48.8% vs 57.1%, P=0.256) between group A to D. The ablation success rate did not differ significantly between subgroups 1 to 4 in every group. However, the rates of excellent response were 86.8%, 52.1%, 25% and 15.2% between subgroups 1 to 4 for group A, respectively (P<0.001). Similarly, there was a significant difference about excellent response rate between subgroups 1 to 4 for groups B, C and D.
After total thyroidectomy, not RAIU but sTg is a prognostic factor for ablation efficacy with a 3.7GBq (100mCi) fixed I dose in patients with DTC.
本研究旨在确定放射性碘摄取（RAIU）和刺激甲状腺球蛋白（sTg）对于分化型甲状腺癌患者消融疗效的预后价值。
我们研究了 466 例分化型甲状腺癌（DTC）患者，这些患者在甲状腺切除术后无远处转移，并在治疗前通过 RAIU 进行评估。根据 RAIU 结果，患者被分为四组，包括：A）RAIU<2%；B）2%≤RAIU<5%；C）5%≤RAIU<10%；D）RAIU≥10%。每组根据 sTg 水平进一步分为四个亚组，即：1）sTg<2ng/mL；2）2ng/mL≤sTg<5ng/mL；3）5ng/mL≤sTg<10ng/mL；4）sTg≥10ng/mL。消融成功定义为消融后 6 个月至 1 年内扫描阴性，其他影像学检查如超声未发现可疑物。良好反应定义为：sTg<1ng/mL，甲状腺球蛋白抗体（TgAb）阴性，影像扫描阴性。
组 A 至 D 的消融成功率分别为 88.3%、88.7%、88.4%和 79%（P=0.779）。组 A 至 D 的良好反应率（64.5%比 63.6%比 48.8%比 57.1%，P=0.256）之间也无显著差异。每组的亚组 1 至 4 之间的消融成功率无显著差异。然而，组 A 的亚组 1 至 4 的良好反应率分别为 86.8%、52.1%、25%和 15.2%（P<0.001）。类似地，组 B、C 和 D 的亚组 1 至 4 之间的良好反应率也有显著差异。
在接受全甲状腺切除术的患者中，3.7GBq（100mCi）固定碘剂量治疗后，不是 RAIU，而是 sTg 是消融疗效的预后因素。
