DTC术后 ^(131)I治疗后体内残留放射性活度与半年后清甲成功关系

The Relationship Between Residual Radioactivity in Vivo After DTC Surgery and^(131)I Treatment and Success Outcome of Clearing ResidualThyroid Tissues after Half a Year

目的探究分化型甲状腺癌(differentiated thyroid cancer,DTC)术后^(131)I治疗后患者体内残留放射性活度与半年后清甲成功之间的关系。方法选取在桂林医学院附属医院首次接受^(131)I清甲治疗的91例DTC患者,收集相关临床资料及测量^(131)I治疗后不同时间点体内残留放射性活度,进行随访研究。首次清甲治疗^(131)I剂量为3.700±0.185 GBq(100±5mCi)。患者体内残留放射性活度用全身动态辐射监测系统进行测定并勾画头颈部辐射剂量。据半年后随访结果将患者分为清甲成功组和清甲未成功组。采用χ^(2)检验、两独立样本t检验、Mann-Whitney U检验比较组间差异,对可能影响清甲成功的因素采用二元Logistic回归分析。结果91例DTC患者术后^(131)I治疗后首次清甲成功率占比为80%(73/91),清甲成功组和未成功组患者的性别、年龄、体质指数(body mass index,BMI)差异均无统计学意义(均P>0.05);超声显像、甲状腺动静态显像差异有统计学意义(均P<0.05)。两组患者全身残留放射性活度在24h差异有统计学意义(P<0.05),48、72h差异均无统计学意义(均P>0.05);两组患者头颈部残留放射性活度在24 h差异有统计学意义(P<0.05),但两组患者^(131)I治疗后在48、72h的残留放射性活度差异均无统计学意义(均P>0.05)。将患者超声显像阳性率、甲状腺动静态显像阳性率、24h全身残留放射性活度等多种因素进行Logistic回归分析显示,24h全身残留放射性活度、甲状腺动静态显像阳性率是DTC患者术后^(131)I治疗半年后清甲成功的独立影响因素(均P<0.05)。结论DTC术后^(131)I治疗后患者24 h全身残留放射性活度、甲状腺动静态显像阳性率与半年后清甲成功有关,可为患者后续的个体化治疗提供参考依据。

Objective To explore the relationship between residual radioactivity in vivo after DTC surgery and^(131)I treatment and success outcome of clearing residual thyroid tissues after half a year.Methods Ninety-one DTC patients who received^(131)I treatment for the first time in the Affiliated Hospital of Guilin Medical University were selected for the study.Relevant clinical data were collected,and the residual radioactivity in vivo at different time points within 72 hours after^(131)I treatment was measured for the follow-up study.The dose of^(131)I for the first time to remove residual thyroid tissue was 3.700±0.185GBq(100±5mCi).The residual radioactivity of the patients was measured with a whole-body dynamic radiation monitoring system and the radiation doses of the head and neck were detected.According to the results of follow-up after half a year,these patients were divided into the successful group(successfully clearing residual thyroid tissues)and the failure group(failed in clearing residual thyroid tissues).χ^(2) test,two independent samples t test and Mann-Whitney U test were adopted to evaluate the differences between groups,and binary logistic regression analysis was used to analyze the factors that could affect the success outcome of clearing residual thyroid tissues.Results The success rate of clearing residual tissues rate of ninety-one DTC patients who received^(131)I treatment for the first time was 80%(73/91).There were no significant differences in gender,age and BMI between the successful group and the failure group(all P>0.05);Ultrasonic imaging and thyroid dynamic and static imaging were significant(all P>0.05).Logistic regression analysis revealed various factors,including patient with the positive rate of ultrasound imaging,the positive rate of thyroid dynamic and static imaging and systemic residual radioactivity at 24h,24h systemic residual radioactivity and the positive rate of thyroid dynamic and static imaging,were independent influencing factors for the success outcome of clear a half a year after postoperative^(131)I treatment in DTC patients(all P<0.05).Conclusion The 24-hour systemic residual radioactivity and the positive rate of thyroid dynamic and static imaging in patients after DTC surgery and after^(131)I treatment are related to the success outcome of clearing residual tissues after half a year,which can provide a useful reference for the follow-up individualized treatment.