Predictive value of stimulated thyroglobulin before the first 131I therapy for children and adolescents with differentiated thyroid carcinoma
10.3760/cma.j.cn321828-20200219-00054
- VernacularTitle:首次 131I治疗前刺激性Tg对儿童及青少年分化型甲状腺癌疗效的预测价值
- Author:
Lina LIU
1
;
Xinyue ZHANG
;
Bin LIU
;
Rui HUANG
;
Lin LI
Author Information
1. 四川大学华西医院核医学科，成都 610041
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2020;40(6):324-328
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of stimulated thyroglobulin (sTg) before the first 131I therapy for children and adolescents with differentiated thyroid carcinoma(DTC). Methods:Between January 2009 and December 2018, a total of 166 children and adolescents DTC patients (28 males, 138 females; age (16.5±3.0) years) from West China Hospital of Sichuan University were retrospectively analyzed. All patients underwent total thyroidectomy and 131I therapy. According to the treatment response evaluated 6-12 months after 131I therapy, patients were divided into excellent response (ER) group and incomplete response (non-ER) group. Clinical and pathological characteristics of 2 groups were compared using independent-sample t test, Mann-Whitney U test, χ2 test or Fisher′s exact test. The independent predictors for 131I treatment response were analyzed by logistic regression analysis. The cut-off value of sTg for predicting ER was determined by receiver operating characteristic (ROC) curve analysis. Results:Sixty-one patients achieved ER, while treatment response in 105 patients was non-ER. The level of sTg in non-ER group was significantly higher than that in ER group (52.5(11.8, 259.1) and 3.0(1.5, 9.7) μg/L; z=6.508, P<0.001). In addition, age, risk stratification, N stage, M stage, ratio of invaded lymph nodes and activities of 131I administered were also significantly different between those 2 groups ( t=2.611, 3.000, z=2.678, χ2=11.432, 16.299; all P<0.05). The level of sTg (odds ratio ( OR)=1.156, P=0.002) and administered activity of 131I ( OR=0.958, P=0.048) were independent predictors for the responses. ROC curve analysis showed that the best cut-off value of sTg for predicting ER was 16.1 μg/L with the sensitivity of 72.4%(76/105) and the specificity of 96.7%(59/61). Conclusions:sTg has the capability of predicting the response to the first 131I therapy in children and adolescents with DTC. When sTg is lower than 16.1 μg/L, the probability of ER increases.
