摘要
目的探讨分化型甲状腺癌(differentiated thyroid cancer,DTC)术后^(131)I治疗后局部淋巴结转移与刺激状态下甲状腺球蛋白(stimulated thyroglobulin,sTg)之间关系。方法回顾性分析2016年9月至2020年9月于郑州大学第一附属医院核医学科行^(131)I 100~150 mCi治疗157例的分化型甲状腺癌患者临床资料,所有患者^(131)I治疗4~5月后停服左甲状腺素钠片3~4周均确诊颈部淋巴结转移病灶。统计患者颈部转移淋巴结个数及直径、颈部淋巴结分区、sTg、性别等临床资料。对sTg值与颈部转移淋巴结病灶个数及直径之间行Spearman相关分析;对于颈部淋巴结复发不同区域之间、sTg阳性与sTg阴性组间患者性别、患者病灶复发部位(颈部单侧或双侧)间差异行χ^(2)检验;对sTg阳性与sTg阴性组间患者所检出病灶个数行t检验。结果在刺激状态下,157例颈部淋巴结转移患者中,Ⅲ区与Ⅳ区是常见转移部位(P<0.05),颈部单侧转移较双侧转移多见(P<0.05)。sTg与颈部转移淋巴结个数及直径之间成线性关系(分别为r=0.517、P<0.05;r=0.361、P<0.05);sTg阳性与sTg阴性患者中性别、病灶数目、病灶复发部位之间差别有统计学意义(P<0.05)。结论sTg可作为DTC术后^(131)I治疗后肿瘤标志物,能反映DTC患者^(131)I治疗后颈部复发淋巴结个数与大小;且sTg阳性与sTg阴性患者之间性别、病灶数目及病灶部位之间有差别;但sTg阴性,不能排除体内无转移病灶。
Objective To explore the relationship between local lymph node metastasis and stimulated thyroglobulin(sTg)after ^(131)I treatment for differentiated thyroid cancer(DTC).Methods A retrospective analysis of the clinical data of 157 patients with differentiated thyroid cancer who underwent ^(131)I 100-150mCi treatment in the Department of Nuclear Medicine of the First Affiliated Hospital of Zhengzhou University from September 2016 to September 2020.Patients who were treated with ^(131)I for 4 to 5 months later stopped taking levothyroxine sodium tablets for 3 to 4 weeks and were diagnosed with cervical lymph node metastasis.Spearman correlation analysis was performed on the sTg value and the number and diameter of cervical metastatic lymph node lesions;χ^(2) test was performed for the difference between different regions of recurrent cervical lymph nodes,gender between sTg-positive and sTg-negative groups,and the difference between the recurrence sites of patients(one or both sides of the neck);t test was performed on the number of lesions detected between the sTg-positive and sTg-negative groups.Results In the stimulated state,among the 157 patients with cervical lymph node metastasis,area Ⅲ and Ⅳwere the common metastatic sites(P<0.05),and unilateral metastases were more common than bilateral metastases(P<0.05).There is a linear relationship between sTg and the number and diameter of cervical metastatic lymph nodes(r=0.517,P<0.05;r=0.361,P<0.05);there was a statistically significant difference between the patient's gender,number of lesions,and location of lesions in patients with sTg positive and sTg negative(P<0.05).Conclusion sTg can be used as a tumor marker for patients with DTC after thyroidectomy and ^(131)I treatment,and there are differences between sTg-positive and-negative in gender,number of lesions,and location of lesions.But sTg negative cannot rule out no metastatic disease in the body.
作者
李祥周
李彦鹏
温鑫
闫志华
程兵
LI Xiang-zhou;LI Yan-peng;WEN Xin;YAN Zhi-hua;CHENG Bing(Department of Nuclear Medicine,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《医药论坛杂志》
2024年第12期1238-1242,共5页
Journal of Medical Forum
基金
河南省重点研发与推广专项(科技攻关)项目(212102310176)。
