Ramesh Sruthi, Fisher Jason C, Curcio Paige, Rothberger Gary D, Prescott Jason, Allendorf John, Suh Insoo, Patel Kepal N
Department of Surgery, NYU Grossman School of Medicine, NYU Langone Health, 550 1st Ave, New York, NY, 10016, USA.
Division of Endocrinology, NYU Langone Health, 550 1st Ave, New York, NY, 10016, USA.
Am J Surg. 2025 Mar;241:116075. doi: 10.1016/j.amjsurg.2024.116075. Epub 2024 Nov 6.
Radioactive iodine therapy (RAI) is a frequently chosen therapy for Graves' disease. The aim of this study was to determine whether RAI for Graves' disease increases the risk of thyroid malignancy.
A retrospective analysis was performed of all Graves' disease patients who underwent thyroidectomy at a single institution between 2013 and 2022. Comparative analyses were performed with cohorts based on RAI therapy as the primary grouping variable.
413 patients were identified, of which 38 received RAI prior to surgery. RAI treated patients were more likely to undergo surgery for known malignancy or indeterminate nodules. RAI patients were also more likely to have malignancies larger than 1 cm. Among RAI treated patients, those who developed malignancy were older at the time of Graves' diagnosis and received early RAI therapy.
Use of RAI for treatment of Graves' disease increases the progression of thyroid carcinoma, but not the prevalence. Older age and early RAI therapy may be risk factors for malignancy in RAI treated patients.
放射性碘治疗（RAI）是Graves病常用的治疗方法。本研究旨在确定Graves病的放射性碘治疗是否会增加甲状腺恶性肿瘤的风险。
对2013年至2022年间在单一机构接受甲状腺切除术的所有Graves病患者进行回顾性分析。以放射性碘治疗作为主要分组变量，对队列进行比较分析。
共确定413例患者，其中38例在手术前接受了放射性碘治疗。接受放射性碘治疗的患者更有可能因已知的恶性肿瘤或不确定的结节而接受手术。接受放射性碘治疗的患者也更有可能患有大于1厘米的恶性肿瘤。在接受放射性碘治疗的患者中，发生恶性肿瘤的患者在Graves病诊断时年龄较大，并接受了早期放射性碘治疗。
使用放射性碘治疗Graves病会增加甲状腺癌的进展，但不会增加患病率。年龄较大和早期放射性碘治疗可能是接受放射性碘治疗患者发生恶性肿瘤的危险因素。
