^(131)I治疗分化型甲状腺癌术后患者TSH、Tg水平与远期预后的相关性分析

Correlation analysis of TSH and Tg levels and long-term prognosis of patients with differentiated thyroid carcinoma after postoperative ^(131)I therapy

目的探究分化型甲状腺癌(differentiated thyroid carcinoma,DTC)术后^(131)I治疗对患者促甲状腺激素(TSH)、甲状腺球蛋白(Tg)的影响及其与远期预后的相关性。方法DTC术后治疗的214例患者中,接受^(131)I联合TSH抑制剂治疗152例(观察组),接受TSH抑制剂治疗62例(对照组),比较2组临床资料及治疗前后TSH、Tg、游离三碘甲状腺原氨酸(FT3)水平变化。随访3年,比较不同预后患者的临床资料,Logistic回归分析DTC术后预后的危险因素。结果治疗后,观察组TSH、Tg水平低于对照组,差异有统计学意义(P<0.05)。治疗后随访3年,对照组总不良预后发生率(32.26%)高于观察组(17.11%),差异有统计学意义(χ^(2)=5.992,P=0.014)。Logisitc分析结果表明,TNM分期Ⅲ/Ⅳ期、淋巴结转移是DTC患者术后预后的危险因素,术后^(131)I治疗为保护因素。结论DTC术后^(131)I治疗可降低患者TSH、Tg水平,降低不良预后发生率。

Objective To explore the effects of ^(131)I therapy on thyroid stimulating hormone(TSH)and thyroglobulin(Tg)of patients with differentiated thyroid cancer(DTC)after surgery and its correlation with long-term prognosis.Methods Of 214 patients after DTC surgery,152 were treated with ^(131)I combined with TSH inhibitors(observation group)and 62 received TSH inhibitors(control group).The clinical data and changes of levels of TSH,Tg and free triiodothyronine(FT3)before and after treatment were compared between the two groups.All were followed up for 3 years.The clinical data of patients with different prognoses were compared.The risk factors of prognosis after DTC surgery were analyzed by Logistic regression analysis.Results After treatment,TSH and Tg levels of the observation group were significantly lower than those of the control group,and the difference was statistically significant(P<0.05).Both groups were followed up for 3 years after treatment.Total incidence of adverse prognoses of the control group(32.26%)was higher than that of the observation group(17.11%),and the difference was statistically significant(χ^(2)=5.992,P=0.014).The results of Logisitc analysis showed that TNM stageⅢ/Ⅳand lymph node metastasis were risk factors of prognosis of DTC patients after surgery,while postoperative ^(131)I therapy was a protective factor.Conclusions ^(131)I therapy after DTC surgery could significantly decrease TSH and Tg levels and reduce the incidence of poor prognoses.