Wang Congcong, Li Yutian, Zhang Yu, Wang Guoqiang, Liu Xinfeng, Zhang Yingying, Wang ZengHua, Si Zengmei, Li Fengqi, Lu Gaixia, Wang Renfei, Wang Xufu
Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Department of Radiology, Qingdao Women and Children's Hospital, Qingdao, Shandong, China.
Future Oncol. 2024 Dec;20(40):3463-3470. doi: 10.1080/14796694.2024.2433407. Epub 2024 Dec 13.
To investigate the prognostic value of pre-ablation stimulated thyroglobulin (ps-Tg) in children and adolescents with persistent differentiated thyroid cancer (DTC) following initial radioiodine therapy (RAI).
MATERIALS & METHODS: Patients were classified into "no clinical evidence of disease" (NED), "biochemical persistent disease" (BPD), and "structural/functional persistent disease" (S/FPD) groups, based on their therapeutic response to initial RAI. BPD patients were further categorized as incomplete response (IR) or Non-IR; S/FPD patients were categorized as remission or Non-remission. Receiver operating characteristic (ROC) curves were used to assess the predictive value of ps-Tg for long-term prognosis. Univariate and multivariate regression analyses were performed to identify risk factors for IR in BPD group and Non-remission in S/FPD group.
In total, 130 patients were included, with NED (32), BPD (61), and S/FPD (37) patients. Multivariate analysis identified therapeutic response to initial RAI as the only independent predictor of IR in the BPD group. ROC analysis determined an optimal ps-Tg threshold of 112.40 ng/mL for predicting Non-remission in S/FPD patients. Multivariate analysis further confirmed that ps-Tg > 112.4 ng/mL was significantly associated with Non-remission.
Findings indicate ps-Tg as a valuable predictor of long-term prognosis in children and adolescents with persistent DTC post initial RAI.
探讨消融前刺激甲状腺球蛋白（ps-Tg）对初次放射性碘治疗（RAI）后持续性分化型甲状腺癌（DTC）儿童及青少年患者的预后价值。
根据患者对初次RAI的治疗反应，将患者分为“无疾病临床证据”（NED）组、“生化持续性疾病”（BPD）组和“结构/功能持续性疾病”（S/FPD）组。BPD患者进一步分为不完全缓解（IR）或非IR；S/FPD患者分为缓解或非缓解。采用受试者操作特征（ROC）曲线评估ps-Tg对长期预后的预测价值。进行单因素和多因素回归分析，以确定BPD组IR和S/FPD组非缓解的危险因素。
共纳入130例患者，其中NED患者32例，BPD患者61例，S/FPD患者37例。多因素分析确定初次RAI的治疗反应是BPD组IR的唯一独立预测因素。ROC分析确定预测S/FPD患者非缓解的最佳ps-Tg阈值为112.40 ng/mL。多因素分析进一步证实，ps-Tg>112.4 ng/mL与非缓解显著相关。
研究结果表明，ps-Tg是初次RAI后持续性DTC儿童及青少年患者长期预后的有价值预测指标。
