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分化型甲状腺癌碘 131 治疗前后尿碘浓度的影响因素:与疗效关系的初步探讨

Influencing Factors of Urinary Iodine Concentration Before and After Radioiodine Therapy for Differentiated Thyroid Cancer: An Initial Exploration of the Relationship With Therapeutic Efficacy.

机构信息

Department of Nuclear Medicine, The Second Affiliated Hospital of Chengdu Medical College, Chengdu, China.

出版信息

Cancer Control. 2024 Jan-Dec;31:10732748241292786. doi: 10.1177/10732748241292786.

Abstract

OBJECTIVE

To investigate the impact of urinary iodine concentration (UIC) and post-stimulatory thyroglobulin (ps-Tg) levels on the therapeutic efficacy of differentiated thyroid cancer (DTC) patients after initial radioiodine therapy, and to analyze the validity of these indicators as prognostic factors.

METHODS

A total of 213 DTC patients received initial radioiodine therapy from June 2022 to September 2023. Demographic data and UIC were collected before and after therapy. Thyrotropin, thyroglobulin (Tg), and thyroglobulin antibody levels were assessed. Iodine uptake rate was measured, and therapeutic efficacy was evaluated 6 months post-therapy. Statistical tests were used for data comparison, and logistic regression analysis for response factors.

RESULTS

Post-therapy UIC and pre-post UIC difference were significantly correlated with Tg levels but not with reaching excellent response (ER) indicated by suppression of Tg levels below 0.2 ug/L. Ps-Tg levels related to therapeutic efficacy, while UIC did not correlate with outcomes. ROC curve analysis found optimal ps-Tg cut-off points for the low-intermediate and high-risk groups classified by primary tumor size, invasion, metastasis, and pathological type.

CONCLUSION

Post-treatment UIC and pre-post UIC difference correlate with ps-Tg levels. Ps-Tg levels are an associated factor for DTC, but UIC changes, despite correlation with ps-Tg, are not significantly related to outcomes and cannot be used as a prognostic factor.

摘要

目的

探讨尿碘浓度(UIC)和刺激后甲状腺球蛋白(ps-Tg)水平对分化型甲状腺癌(DTC)患者初始放射性碘治疗后的疗效的影响,并分析这些指标作为预后因素的有效性。

方法

共 213 例 DTC 患者于 2022 年 6 月至 2023 年 9 月接受初始放射性碘治疗。收集治疗前后的人口统计学数据和 UIC。评估促甲状腺激素、甲状腺球蛋白(Tg)和甲状腺球蛋白抗体水平。测量碘摄取率,并在治疗后 6 个月评估治疗效果。采用统计学检验进行数据比较,采用逻辑回归分析进行反应因素分析。

结果

治疗后 UIC 和治疗前后 UIC 差值与 Tg 水平显著相关,但与 Tg 水平抑制至 0.2μg/L 以下的优秀反应(ER)无关。ps-Tg 水平与疗效相关,而 UIC 与结果无关。ROC 曲线分析发现,根据原发肿瘤大小、侵袭、转移和病理类型,对低中危和高危组进行分类时,ps-Tg 的最佳截断点。

结论

治疗后 UIC 和治疗前后 UIC 差值与 ps-Tg 水平相关。ps-Tg 水平是 DTC 的一个相关因素,但 UIC 的变化虽然与 ps-Tg 相关,但与结局无显著关系,不能作为预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8a7/11483681/0933613aefb3/10.1177_10732748241292786-fig1.jpg

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