上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (3): 268-.

• 专题报道（甲状腺癌核素治疗） • 上一篇    下一篇

腺叶切除不完全分化型甲状腺癌131I疗效观察

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）

Efficacy of 131I thyroid remnant ablation in patients with differentiated thyroid carcinoma after partial thyroidectomy

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 研究腺叶切除不完全的分化型甲状腺癌（DTC）患者实施放射性碘（131I）清除甲状腺组织（清甲）治疗的效果。方法 回顾性分析DTC术后接受131I清甲治疗的103例患者的临床资料。根据甲状腺平面显像结果分为腺叶切除不完全组（n=33）和腺叶切除完全组（n=70）。首次131I清甲剂量为1.11~3.7 GBq（30~100 mCi）。3~6个月后复查并评估清甲效果：若诊断剂量131I全身显像显示颈部无放射性摄取即认为清甲完全；若有放射性摄取，即认为清甲不完全，需再次行131I清甲治疗，定期随访复查清甲效果。结果 实施3次清甲治疗的成功率，腺叶切除完全组分别为61.43%、88.89%和100%，腺叶切除不完全组分别为21.21%、46.15%和78.57%。统计学分析表明，腺叶切除完全组的第1、2次清甲疗效与腺叶切除不完全组的第2、3次清甲疗效比较，差异均无统计学意义（P>0.05）。结论 对于甲状腺腺叶切除不完全的DTC患者，实施131I治疗的一次清甲成功率较低，但经2~3次治疗后同样可达到较高的清甲疗效。尤其适用于再次手术可能会导致严重的手术并发症或拒绝再次手术的患者。

关键词: 分化型甲状腺癌, 甲状腺腺叶切除, 放射性碘, 清除甲状腺组织

Abstract:

Objective To observe the efficacy of radioactive iodine (131I) thyroid remnant ablation in patients with differentiated thyroid carcinoma (DTC) after partial thyroidectomy. Methods The clinical data of 103 patients with 131I thyroid remnant ablation after DTC were retrospectively analysed. Patients were divided into partial thyroidectomy group （n=33）and complete thyroidectomy group （n=70）according to the findings of thyroid planar imaging. The first ablation dose was 1.11—3.7 GBq (30—100 mCi). Diagnostic 131I whole body scan was used to evaluate the efficacy of ablation 3 to 6 months later. If no visible radioactive uptake in thyroid bed was found, the ablation was defined to be complete. Otherwise, the ablation was defined to be partial, and patients needed a second or third dose of 131I with routine follow-up. Results After the first, second and third ablation, the rates of complete ablation in complete thyroidectomy group were 61.43%, 88.89% and 100%, and those in partial thyroidectomy group were 21.21%, 46.15% and 78.57%. There was no significant difference between the efficacy of the first and second ablation in complete thyroidectomy group and that of the second and third ablation in partial thyroidectomy group (P>0.05). Conclusion The efficacy of 131I thyroid remnant ablation in patients with DTC after partial thyroidectomy may not be favourable at the first dose, while a high rate of complete ablation can be achieved at the second or third dose.

Key words: differentiated thyroid carcinoma, thyroidectomy, radioiodine, thyroid remnant ablation