手术联合^(131)I、甲状腺片治疗甲状腺乳头状癌的效果

Effect of surgery combined with ^(131)I and Thyroid Tablets in the treatment of thyroid papillary carcinoma

目的探讨手术联合^(131)I、甲状腺片治疗甲状腺乳头状癌的效果。方法将2013年3月~2014年3月在我院普外科治疗的78例甲状腺乳头状癌患者随机分为对照组和观察组,每组各39例。对照组采用胸乳入路腔镜手术切除甲状腺治疗,观察组在此基础上服用^(131)I、甲状腺片治疗,比较两组3年生存率、复发率、术后各项细胞因子水平。结果观察组3年生存率明显高于对照组,而复发率明显低于对照组,差异有统计学意义(P<0.05);两组治疗后3、6个月的血清肿瘤抑制基因(p53)、细胞凋亡信号受体(Fas)、肿瘤坏死因子-α(TNF-α)细胞周期素E(Cyclin E)蛋白与术后即刻比较,差异均有统计学意义(P<0.05);观察组治疗后3、6个月p53、Fas、TNF-α、Cyclin E与对照组比较,差异有统计学意义(P<0.05)。结论手术联合^(131)I、甲状腺片治疗甲状腺乳头状癌效果显著,能持续抑制肿瘤发展,延长生存周期,降低复发率,有积极的临床意义。

Objective To investigate the effect of surgery combined with^131I and Thyroid Tablets in the treatment of papillary thyroid carcinoma.Methods 78 patients with thyroid papillary carcinoma who were treated in the department of general surgery in our hospital from March 2013 to March 2014 were randomly divided into two groups,39 cases in each group.The control group was given thyroidectomy via endoscopic chest-breast approach.On this basis,the observation group was given～（131）I and Thyroid Tablets for treatment.Three-year survival rate,recurrence rate and postoperative cytokines levels were compared between the two groups.Results The 3-year survival rate in the observation group was significantly higher than that in the control group,while the recurrence rate was significantly lower than that in the control group,the differences were statistically significant（P〈0.05）;serum tumor suppressor gene（p53）,Fas,TNF-α and Cyclin E protein in the two groups at 3 months and 6 months after treatment were compared with those immediately after the surgery,the differences were statistically significant（P〈0.05）;the levels of p53,Fas,TNF-αand Cyclin E in the observation group at 3 months and 6 months after treatment were significantly different from those in the control group（P〈0.05）.Conclusion Surgery combined with～（131）I and Thyroid Tablets has a significant effect in the treatment of papillary thyroid carcinoma,which can continue to inhibit tumor development,extend the life cycle and reduce the recurrence rate,and has a positive clinical significance.