摘要
目的探讨分化型甲状腺癌(DTC)患者术后采用131I去除残余组织的临床疗效及影响临床疗效的因素。方法选择行甲状腺全切或次全切的分化型甲状腺癌患者205例为研究对象,术后采用131I去除残余组织,首次给予50~200 mCi口服,其后根据甲状腺激素水平调整甲状腺片用量,治疗6个月后评价131I去除残余组织的临床效果。根据临床疗效不同分为有效组和无效组,采用单因素及多因素分析法分析131I去除残余组织临床疗效的影响因素。结果131I去除残余组织的总有效率为90.24%(185/205);131I治疗后残余甲状腺组织体积有效组小于无效组,差异有统计学意义(P<0.05)。单因素分析结果显示,年龄、病程、肿瘤分期、原发灶、131I剂量和TG水平是影响DTC术后131I治疗效果的因素(P<0.05);多因素logistic回归分析显示,高龄(OR=1.574,95%CI=0.753~6.382)、病程(OR=1.618,95%CI=0.843~7.625)、肿瘤分期为Ⅲ期和Ⅳ期(OR=2.346,95%CI=1.275~9.763)、双侧病灶(OR=1.226,95%CI=0.589~5.347)、高水平TG(OR=1.983,95%CI=0.975~8.763)是DTC术后131I治疗效果的独立影响因素。结论DTC患者甲状腺切除术后采用131I去除残余组织疗效理想,其疗效受患者病程、年龄、肿瘤分期、原发灶和TG水平的影响明显。
Objective To investigate the clinical effect of 131I in the removal of residual tissues in patients with differentiated thyroid carcinoma(DTC)and the influencing factors.Methods The 205 patients with differentiated thyroid cancer who underwent total or subtotal thyroidectomy were selected as the study subjects.After operation,131I was used to remove residual tissues,and 50-200 mCi was given orally for the first time.The dosage of thyroid tablets was adjusted according to the level of thyroid hormone.The clinical effect of 131I in removing residual tissues was evaluated after 6 months of treatment.According to the different clinical efficacy,the patients were divided into effective group and ineffective group.The influencing factors of the clinical efficacy of 131I in removing residual tissue were analyzed by single factor and multi-factor analysis.Results The total effective rate of 131I in removing residual thyroid tissue was 90.24%(185/205),and volume of 131I of residual thyroid tissue after treatment of the effective group was smaller than that of the ineffective group(P<0.05).Univariate analysis showed that age,course of disease,tumor stage,primary focus,131I dose and TG level were the factors influencing the therapeutic effect of 131I after DTC(P<0.05).Multivariate logistic regression analysis showed that age(OR=1.574,95%CI=0.753~6.382),course of disease(OR=1.618,95%CI=0.843~7.625),stage of tumor were III.Stage I and IV(OR=2.346,95%CI=1.275~9.763),bilateral lesions(OR=1.226,95%CI=0.589~5.347),high level of TG(OR=1.983,95%CI=0.975~8.763)were independent influencing factors of 131I treatment after DTC.Conclusion The effect of 131I removal of residual tissue after thyroidectomy in DTC patients is ideal.The effect of 131I removal is significantly affected by the course of disease,age,stage of tumors,primary focus and TG level.
作者
王永宁
刘姗姗
刘玉林
邱刚
周彦
任梦秋
卢颖俏
WANG Yongning;LIU Shanshan;LIU Yulin(Kaifeng Central Hospital,Kaifeng,475000)
出处
《实用癌症杂志》
2020年第4期578-582,共5页
The Practical Journal of Cancer
基金
2016年度河南省医学科技攻关计划项目(编号:162102310015)。
关键词
分化型甲状腺癌
碘-131
残余甲状腺组织
临床疗效
影响因素
Differentiated thyroid cancer
Iodine-131
Residual thyroid tissue
Clinical efficacy
Influencing factors
