Department of Nuclear Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan Province, China.
Department of Nuclear Medicine, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Sichuan Province, China,
Arch Endocrinol Metab. 2023 Mar 10;67(2):197-205. doi: 10.20945/2359-3997000000538. Epub 2023 Jan 17.
The purpose of this study was to investigate the effect and influencing factors of postsurgical radioactive iodine (RAI) therapy for patients with low- and intermediate-risk differentiated thyroid cancer (DTC).
A retrospective analysis of 423 low- and intermediaterisk DTC patients admitted to the Department of Nuclear Medicine, Sichuan Provincial People's Hospital from January 2005 to December 2020 was performed. All patients were treated with surgery, had a postoperative pathological diagnosis, and were treated with RAI, including 89 males and 334 females. Recurrence risk stratification: 143 cases were low-risk, and 280 cases were intermediaterisk.
The excellent response (ER) rate for low- and intermediate-risk were 93.7% and 78.2%, respectively (P < 0.05). There were significant differences in age, cumulative dose of [I], and pretreatment stimulated-Tg (pre-Tg) levels between the low- and intermediate-risk groups (P < 0.05). There were significant differences in the cumulative dose of I and pre-Tg levels between ER and the non-ER group (P < 0.05). The area under the curve (AUC) values were 0.799 in the low-risk group, and 0.747 in the intermediate-risk group for the ROC curve by ER status of pre-Tg. The ER rate with RAI treatment decreased with an increase in pre-Tg levels.
Pre-Tg was an important factor for RAI treatment decision-making and prognostic evaluation and differed between low-risk and intermediate-risk DTC. Aggressive RAI therapy was recommended for low-risk DTC with pre-Tg ≥ 20.0 ng/mL and in intermediate-risk group with pre-Tg ≥ 10.0 ng/mL.
本研究旨在探讨低危和中危分化型甲状腺癌（DTC）患者术后放射性碘（RAI）治疗的效果及影响因素。
回顾性分析 2005 年 1 月至 2020 年 12 月四川省人民医院核医学科收治的 423 例低危和中危 DTC 患者，均行手术治疗，术后病理诊断明确，行 RAI 治疗，其中男 89 例，女 334 例。复发风险分层：低危 143 例，中危 280 例。
低危和中危患者的完全缓解（ER）率分别为 93.7%和 78.2%（P<0.05）。低危和中危组患者年龄、[I]累积剂量和治疗前促甲状腺球蛋白（pre-Tg）水平差异有统计学意义（P<0.05）。ER 组和非 ER 组的 I 累积剂量和 pre-Tg 水平差异有统计学意义（P<0.05）。低危和中危组以 ER 状态为因变量的 pre-Tg 的 ROC 曲线下面积（AUC）值分别为 0.799 和 0.747。
pre-Tg 是 RAI 治疗决策和预后评估的重要因素，在低危和中危 DTC 之间存在差异。对于 pre-Tg≥20.0ng/ml 的低危 DTC 和 pre-Tg≥10.0ng/ml 的中危组，建议行积极的 RAI 治疗。
