中高危分化型甲状腺癌手术后首次^(131)I治疗的疗效分层及影响因素

An Analysis of Effect Stratification and Influencing Factors After the First^(131)I Treatment After Surgery for Intermediate and High-Risk Differentiated Thyroid Cancer

目的研究中、高危分化型甲状腺癌患者术后^(131)I治疗的动态疗效评估,并探讨影响疗效的有关因素。方法回顾性收集就诊于苏州大学第一附属医院的318例DTC患者。按照治疗疗效评估体系对4种治疗疗效进行评估并分析。结果中高危患者各疗效组间差异有统计学意义。ps-Tg≤3.53ng/mL,时间间隔≤233d及^(131)I治疗剂量<150mCi是中危患者ER独立预测因素。ps-Tg≥11.8ng/mL是中危患者SIR的独立预测因素。ps-Tg≤1.04ng/mL是高危患者ER的独立预测因素。ps-Tg≥7.58ng/mL、远处转移是高危患者SIR的独立预测因素。结论ps-Tg≤3.53ng/mL、时间间隔≤233d的中危患者首次^(131)I治疗后的疗效较好;ps-Tg≥11.8ng/mL的中危患者首次^(131)I治疗后疗效较差。ps-Tg≤1.04ng/mL的高危患者首次^(131)I治疗后疗效较好;ps-Tg≥7.58ng/mL、远处转移的高危患者首次^(131)I治疗后疗效较差。

Objective To evaluate the dynamic efficacy of ^(131) I therapy in patients with moderately and high-risk differentiated thyroid cancer,and to explore the relevant factors affecting the efficacy.Methods 318 DTC patients from the First Affiliated Hospital of Soochow University were retrospectively collected.The evaluation analysis was conducted according to the four therapeutic effects in the therapeutic effect response evaluation system.Results There was a statistically significant difference among the treatment groups of patients with medium and high risks.ps-Tg≤3.53ng/mL,time interval≤233 days and ^(131) I therapeutic dose<150 mCi were independent predictors of ER in patients with moderate risk.ps-Tg≥11.8ng/mL was an independent predictor of SIR in patients with moderate risk.ps-Tg≤1.04ng/mL was an independent predictor of ER in high-risk patients.ps-Tg≥7.58ng/mL and distant metastasis were independent predictors of SIR in high-risk patients.Conclusion The intermediate risk patients with ps-Tg≤3.53ng/mL and time interval≤233 days have a better efficacy after the first ^(131) I treatment;The intermediate risk patients with ps-Tg≥11.8ng/mL have a poor efficacy after the first ^(131) I treatment.The high-risk patients with ps-Tg≤1.04ng/mL have a better effect after the first ^(131) I treatment;High-risk patients with ps-Tg≥7.58 ng/mL and distant metastasis have a poor efficacy after the first ^(131) I treatment.