上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (3): 253-.

• 专题报道（甲状腺癌核素治疗） • 上一篇    下一篇

含碘造影剂对分化型甲状腺癌肺转移病灶131I疗效的影响

盛矢薇, 陈立波, 陆汉魁, 罗全勇   

  1. 上海交通大学 第六人民医院核医学科, 上海 200233
  • 出版日期:2010-03-25 发布日期:2010-03-24
  • 通讯作者: 陈立波, 电子信箱: libochen888@hotmail.com。
  • 作者简介:盛矢薇（1981—）, 女, 住院医师, 学士；电子信箱: sswfrandy1981@hotmail.com。
  • 基金资助:

    国家自然科学基金（30700187）；上海市青年科技启明星计划（08QA14040）

Effects of iodinated contrast media on therapeutic effect of 131I in patients with pulmonary metastases from differentiated thyroid carcinoma

SHENG Shi-wei, CHEN Li-bo, LU Han-kui, LUO Quan-yong   

  1. Department of Nuclear Medicine, The Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, China
  • Online:2010-03-25 Published:2010-03-24
  • Supported by:

    National Natural Science Foundation of China, 30700187；Shanghai Rising-Star Program, 08QA14040

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摘要：

目的 应用放射性碘(131I)扫描研究含碘造影剂对分化型甲状腺癌患者肺转移病灶131I治疗效果的影响。方法 收集82例分化型甲状腺癌肺转移患者的临床资料，根据实施131I治疗前患者是否接受增强CT扫描及其与治疗的间隔时间分为增强CT扫描1组（间隔时间<3个月，n=32）、增强CT扫描2组（间隔时间≥3个月，n=27）和未接受增强CT扫描的阴性对照组（n=23）。131I治疗后，131I扫描观察和分析各组肺转移病灶的摄碘情况并进行疗效评估。结果 肺转移病灶131I扫描阳性率比较显示，增强CT扫描1组明显低于增强CT扫描2组和阴性对照组（P<0.05），增强CT扫描2组与阴性对照组比较差异无统计学意义（P>0.05）。三组131I治疗有效率比较差异无统计学意义（P>0.05）。增强CT扫描1、2组肺转移病灶实施首次131I治疗后，131I扫描表现为阴性患者的疗效差于阳性患者。结论 131I扫描对甲状腺癌肺转移患者肺内病灶的131I治疗效果具有良好的预测价值；接受131I治疗前3个月内使用含碘造影剂会影响该类患者肺内病灶对131I的摄取。

关键词: 含碘造影剂, 甲状腺癌, 肺转移, 放射性碘

Abstract:

Objective To explore the effects of iodinated contrast media on therapeutic effect of 131I in patients with pulmonary metastases from differentiated thyroid carcinoma. Methods The clinical data of 82 patients with pulmonary metastases from differentiated thyroid carcinoma were collected, and were classified into three groups according to the conduction of contrast CT scan: contrast CT scan group 1(<3 months of the interval between 131I treatment and contrast CT scan, n=32), contrast CT scan group 2 (≥3 months of the interval between 131I treatment and contrast CT scan, n=27) and negative control group (without contrast CT scan, n=23). After 131I treatment, the condition of iodine intake of pulmonary metastatic lesions in each group was observed and analysed by 131I scan, and the therapeutic effect was evaluated. Results The positive rate of iodine intake of pulmonary metastatic lesions revealed by 131I scan in contrast CT scan group 1 was significantly lower than those of contrast CT scan group 2 and negative control group（P<0.05）, while there was no significant difference between contrast CT scan group 2 and negative control group（P>0.05）. There was no significant difference in therapeutic effect of 131I treatment among three groups （P>0.05）. However, the therapeutic effect of patients with negative results in initial 131I treatment was poorer than those with positive results. Conclusion 131I scan may predict the therapeutic effect of 131I treatment in patients with pulmonary metastases from differentiated thyroid carcinoma, and the application of iodinated contrast media within 3 months before 131I treatment may affect the iodine intake of pulmonary metastatic lesions.

Key words: iodinated contrast media, thyroid carcinoma, pulmonary metastasis, radioactive iodine