Predictive value of the differential distribution of peripheral lymphocyte subsets before and after the first 131I treatment on therapeutic response in patients with papillary thyroid cancer
10.3760/cma.j.cn321828-20240119-00026
- VernacularTitle:甲状腺乳头状癌患者首次 131I治疗前后外周血淋巴细胞亚群的差异分布对 131I疗效的预测价值
- Author:
Junyu ZHANG
1
;
Di FAN
;
Zhiyong SHI
;
Tiane LUO
;
Zhifang WU
;
Hongliang WANG
;
Keyi LU
;
Suyun YANG
;
Lixiang WU
;
Tingting HU
;
Yuanyuan MOU
;
Sijin LI
;
Haiyan LIU
Author Information
1. 山西医科大学第一医院核医学科、分子影像精准诊疗省部共建协同创新中心，太原 030001
- Keywords:
Thyroid neoplasms;
Radiotherapy;
Iodine radioisotopes;
Lymphocyte subsets;
Treatment outcome;
Forecasting
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2024;44(12):730-735
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of differential distribution of peripheral lymphocyte subsets before and after the first 131I treatment on the therapeutic response to 131I treatment in patients with papillary thyroid cancer (PTC). Methods:A retrospective study was conducted on 46 PTC patients (16 males, 30 females, age 20-77 years) who underwent total thyroidectomy and received 131I treatment between January 2021 and August 2021 in First Hospital of Shanxi Medical University. Peripheral blood lymphocyte subsets (T, B, CD4 + T, CD8 + T, natural killer (NK), helper T (Th)1, Th2, Th17, and regulatory T (Treg) cells) were measured 1-2 d before and 30 d after 131I treatment. Based on serological and imaging evidence, therapeutic response at 6-12 months post- 131I therapy was categorized as either excellent response (ER) or non-excellent response (NER). Differences of preablative stimulated thyroglobulin (psTg) and clinical baseline characteristics between two groups were assessed by using independent-sample t test, paired t test, or Mann-Whitney U test. Predictive value of lymphocyte subsets before and after 131I treatment for therapeutic response was assessed through logistic regression analysis, ROC curve analysis, and decision curve analysis (DCA). Results:In ER group ( n=33) and NER group ( n=13), most lymphocyte subsets showed different degrees of reduction 30 d after 131I treatment compared to before 131I treatment, such as T, B, CD4 + T and Th1 cells in ER group, as well as T, B, CD4 + T, Th1, Th2, Th17, and Treg cells in NER group ( t values: 2.41-9.57, all P<0.05). Before 131I treatment, NER group had significantly higher levels of psTg, Th2, Th17, and Treg cells compared to the ER group ( t values: from -3.32 to -2.48, U=29.00, all P<0.05). After 131I treatment, most of lymphocyte subsets in NER group (T, B, CD4 + T, CD8 + T, Th1 and Treg cells) showed higher trend than those in ER group but without statistical significances ( t values: from -1.12 to -0.06, all P>0.05). Th2 cells before 131I treatment (odds ratio ( OR)=25.00, 95% CI: 1.36-459.10, P=0.030) was identified as a risk factor for NER. ROC curve analysis indicated that AUCs of psTg and Th2 cells for predicting therapeutic response were 0.932 and 0.790, respectively, which was 0.958 for the combined psTg and Th2 cells. DCA showed that within the threshold probability range of 10%-60%, the curves for psTg, Th2 cells, and the combined psTg and Th2 cells were all higher than the extreme curve, suggesting good effect. Conclusions:Most lymphocyte subsets decrease to varying degrees, and NER group shows a significant decrease 30 d after 131I treatment. Th2 cells may be a risk factor for poor response to 131I treatment, providing a certain value in predicting the therapeutic response to 131I treatment.
