分化型甲状腺癌患者^(131)I治疗前碘盐饮食与疗效的关系

Relationship between iodized salt diet and therapeutic efficacy in differentiated thyroid cancer patients before ~(131)I therapy

目的:探讨分化型甲状腺癌(DTC)患者^(131)I治疗前正常碘盐饮食是否是疗效的影响因素。方法:选取2021年7月至2022年10月就诊于郑州大学第一附属医院核医学科行甲状腺全切术后首次行^(131)I治疗的DTC患者329例,首先将患者分为中低危组(n=196)和高危组(n=133),按照疗效分别将中低危、高危患者再次分为疗效满意组和疗效不满意组,比较患者年龄、性别、T分期、N分期、治疗前刺激性甲状腺球蛋白(ps-Tg)、是否碘盐饮食间的差异。采用Logistic回归模型分析DTC患者预后的影响因素。结果:Logistic回归结果显示,在中低危患者中,治疗前ps-Tg水平对患者预后有影响[OR(95%CI):1.561(1.346~1.811),P<0.001],是否正常碘盐饮食对DTC患者预后无影响[OR(95%CI):1.017(0.469~2.205),P=0.965];在高危患者中,治疗前ps-Tg水平[OR(95%CI):1.021(1.005~1.037),P=0.010]、T分期[OR(95%CI):5.812(2.049~16.489),P<0.001]和N分期[OR(95%CI):0.309(0.111~0.866),P=0.025]对患者预后有影响,是否正常碘盐饮食与患者预后无关[OR(95%CI):2.398(0.956~6.014,P=0.062]。结论:正常碘盐饮食对DTC患者^(131)I治疗效果没有影响。

Aim:To investigate whether a normal iodized salt diet prior to ~(131)I treatment is an influencing factor for efficacy in patients with differentiated thyroid cancer(DTC).Methods:A total of 329 DTC patients who were first treated with ~(131)I after total thyroidectomy in the Department of Nuclear Medicine of the First Affiliated Hospital of Zhengzhou University from July 2021 to October 2022 were selected,and firstly,the patients were classified into low and medium-risk group(n=196) and high-risk group(n=133),and then reclassified into the group of satisfactory response and non-satisfactory response group(non-Excellent Response,Non-ER) according to the therapeutic efficacy.The differences between groups in terms of age,gender,T-stage,N-stage,pretreatment stimulated thyroglobulin(ps-Tg) level,and whether or not they were on an iodized salt diet were compared.Logistic regression model was used to analyze the factors influencing the prognosis of DTC patients.Results:Logistic regression analysis showed that among low and medium-risk patients,pretreatment ps-Tg level had an effect on patients′ prognosis [OR(95%CI):1.561(1.346~1.811),P<0.001],and whether or not to have normal iodzed diet had no effect on the prognosis of DTC patients[OR(95%CI):1.017(0.469-2.205),P=0.965];among high-risk patients,pretreatment ps-Tg level [OR(95%CI):1.021(1.005-1.037),P=0.010],T-stage [OR(95%CI):5.812(2.049-16.489),P<0.001] and N-stage [OR(95%CI):0.309(0.111-0.866),P=0.025] had effects on patients′ prognosis,and whether or not having a normal iodized salt diet was not associated with patients′ prognosis [OR(95%CI):2.398(0.956-6.014),P=0.062].Conclusions:Normal iodized salt diet has no effects on the outcome of ~(131)I therapy in patients with DTC.