手术联合131I、甲状腺片治疗甲状腺乳头状癌疗效观察

Clinical value of 131I and operation in the treatment of papillary thyroid carcinoma

目的观察与探讨手术联合131I、甲状腺片治疗甲状腺乳头状癌的疗效。方法选择自2008年1月~2012年1月来安吉县人民医院治疗的45例甲状腺乳头状癌患者,所有患者均接受甲状腺全切手术治疗,并在术后均给予患者131I及甲状腺片治疗,对术后即刻、3个月、6个月时患者的P53、Fas、TNF-α以及Cyclin E水平进行检测,并对患者进行为期5年的随访,观察治疗效果。结果与术后即刻相比,术后3、6个月时患者的P53、Fas以及TNF-α水平均有显著升高,而Cyclin E水平则明显降低（P〈0.05）,但术后3、6个月时以上指标均无明显差异;随访5年后,复发率为4.4%,远处转移率为2.2%。结论手术联合131I、甲状腺片治疗甲状腺乳头状癌效果良好,可作为临床首选治疗方案。

Objective To investigate the effect of surgical treatment combined with 131I in the treatment of thyroid papillary carcinoma.Methods45 cases of papillary thyroid cancer patients were selected from January 2008 to January 2012 in our hospital.All of the patients were treated with total thyroidectomy surgical,postoperative underwent thyroid hormone and 131I radionuclide therapy,The patients were followed up.ResultsAt 3 months or 6 months after operation,the levels of serum P53,Fas and TNF-a were significantly higher than immediate time after surgery （P〈0.05） and cyclin E protein levels were significantly lower than immediate time after surgery （P〈0.05）.There were no difference of serum P53,Fas,TNF-and Cyclin E protein levels between at 3 months and 6 months after operation.During five years of follow-up, the 5-year recurrence rate of 4.4%,and the distant metastasis rate was 2.2%.ConclusionOperation combined with 131I radionuclide therapy has good clinical results,could be used as the first choice for clinical treatment.