上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (3): 249-.

• 专题报道（甲状腺癌核素治疗） • 上一篇    下一篇

分化型甲状腺癌131I疗效影响因素分析

傅宏亮, 杜学亮, 顾振辉, 邹仁健, 吴 真, 王 辉   

  1. 上海交通大学 医学院新华医院核医学科, 上海 200092
  • 出版日期:2010-03-25 发布日期:2010-03-24
  • 通讯作者: 王 辉, 电子信箱: wanghuishanghai@hotmail.com。
  • 作者简介:傅宏亮(1969—), 男, 副主任医师, 硕士；电子信箱: fuhongliang@hotmail.com。
  • 基金资助:

    上海市重点学科建设项目（S30203）

Analysis of influential factors for efficacy of 131I thyroid remnant ablation for differentiated thyroid carcinoma

FU Hong-liang, DU Xue-liang, GU Zhen-hui, ZOU Ren-jian, WU Zhen, WANG Hui   

  1. Department of Nuclear Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China
  • Online:2010-03-25 Published:2010-03-24
  • Supported by:

    Shanghai Leading Academic Discipline Project, S30203

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摘要：

目的 对分化型甲状腺癌(DTC)术后患者实施放射性碘（131I）清除残余甲状腺（清甲）治疗，分析影响清甲效果的相关因素。方法 收集DTC术后接受131I清甲治疗患者的临床资料。采用Binary Logistic回归分析和χ2检验，分析患者性别和年龄、DTC的病理学类型和有无转移、甲状腺残余组织大小、血清促甲状腺激素（TSH）水平、甲状腺摄碘率和131I治疗剂量对清甲疗效的影响。结果 共收集183例患者资料，其中一次清甲完全者109例，占59.56%。Binary Logistic回归分析表明，残余甲状腺大小和131I治疗剂量分别是影响清甲效果的主要因素（Wald=8.59，P=0.003；Wald=6.40，P=0.011）。χ2检验结果显示，与血清TSH水平≥30 μIU/mL患者比较，血清TSH水平<30 μIU/mL患者的清甲效果较差（χ2=7.291，P=0.007）；而血清TSH水平<60 μIU/mL与≥60 μIU/mL患者间清甲效果比较，差异无统计学意义（P>0.05）。结论 在分化型甲状腺癌患者的131I清甲治疗中，残余甲状腺大小和131I治疗剂量是影响清甲效果的主要因素。血清TSH水平≥30 μIU/mL者的清甲疗效较好，而过高的血清TSH水平则并不能使清甲效果进一步提高。

关键词: 分化型甲状腺癌, 放射性碘, 清甲治疗, 残余灶, 治疗剂量

Abstract:

Objective To analyse the influential factors for efficacy of radioiodine (131I) thyroid remnant ablation for differentiated thyroid carcinoma (DTC) after operation. Methods The clinical data of patients undergoing 131I thyroid remnant ablation after operation for DTC were collected. Binary Logistic regression analysis and chi-square test were employed to analyse the effects of gender, age, pathologic type, metastasis, volume of thyroid remnant tissues, serum thyroidstimulating hormone (TSH) level, rate of thyroid iodine uptake and 131I ablative dose on efficacy of thyroid remnant ablation. Results The clinical data of 183 patients were collected, among whom 109 (59.56%) achieved successful thyroid remnant ablation at first dose. Binary Logistic regression analysis indicated that the volume of thyroid residue and ablative dose of 131I were the main factors for the efficacy of ablation (Wald=8.59, P=0.003; Wald=6.40, P=0.011). Chi-square test revealed that the ablation efficacy in patients with TSH≥30 μIU/mL was higher than that in those with TSH<30 μIU/mL (χ2=7.291, P=0.007), while there was no significant difference between patients with TSH<60 μIU/mL and those with TSH≥60 μIU/mL (P>0.05). Conclusion The volume of thyroid residue and ablative dose are the main factors for the efficacy of 131I thyroid ablation for DTC. Patients with serum TSH≥30 μIU/mL may have favourable efficacy in thyroid ablation, while excessive serum TSH level may not yield better result.

Key words: differentiated thyroid carcinoma, radioiodine, thyroid remnant ablation, thyroid residue, therapeutic dose