Analysis of the efficacy and influencing factors after the First 131Ⅰ treatment after surgery for differentiated thyroid cancer
10.12092/j.issn.1009-2501.2024.12.014
- VernacularTitle:分化型甲状腺癌术后首次131Ⅰ治疗后疗效及影响因素分析
- Author:
Shaoneng TAO
1
;
Junliang GE
1
;
Jiwen YANG
1
;
Xiaolei CHEN
1
;
Weili YIN
1
;
Yingying WANG
1
;
Xiaocen LIU
1
Author Information
1. 皖南医学院第一附属医院核医学科,芜湖 241001,安徽
- Publication Type:Journal Article
- Keywords:
differentiated thyroid cancer;
iodine radioisotopes;
thyroglobulin;
therapeutic efficacy;
influencing factors
- From:
Chinese Journal of Clinical Pharmacology and Therapeutics
2024;29(12):1435-1440
- CountryChina
- Language:Chinese
-
Abstract:
AIM:To explore the therapeutic effica-cy and influencing factors of differentiated thyroid cancer(DTC)after the first postoperative 131Ⅰ treat-ment.METHODS:We retrospectively analyzed the clinical data of 116 DTC patients treated with 131Ⅰfor the first time after thyroid cancer surgery in the Department of Nuclear Medicine of the First Affili-ated Hospital of Wannan Medical College,analysed their therapeutic efficacy,and Univariate and multi-variate Logistic analyses were performed for the factors that may affect the efficacy of the treat-ment,respectively,and established ROC curves to analyse the diagnostic and ER efficacy of those with psTg and TTR that had a significant effect on the multifactorial Logistic analyses.RESULTS:In DTC patients who were followed up 3-9 months af-ter the first postoperative 131Ⅰ treatment,69.0%(80/116)achieved ER.Univariate analysis revealed no statistical significance between ER and NER groups in terms of age,gender,TSH,TgVR,maximum tu-mour diameter,presence of lymph node metasta-sis,bilaterality of tumour,multifocality and clinical stage(P>0.05).While 131Ⅰ dose,nsTg,psTg,TgV and TTR(Tg/TSH ratio)were statistically significant(P<0.05).The results of multifactorial Logistic analysis showed that psTg and TTR were independent risk factors for the first 131Ⅰ treatment after DTC,with a psTg OR of 5.950(95%CI 1.437-24.639,P<0.05)and a TTR OR of 4.137(95%CI 1.073-15.947,P<0.05).The best threshold value of psTg for ROC curve analysis to predict the efficacy of the first postoperative 131Ⅰ treatment for DTC was 8.935 μg/L,with a sensitivity of 80.6%,a specificity of 83.6%,and a Yuden's index of 0.64.And the best threshold value of TTR for predicting the efficacy of the first postoperative 131Ⅰ treatment for DTC was 125.72 ng/mIU,with a sensitivity,specificity of 80.6%and 91.2%,and the Yuden index was 0.618.psTg and TTR areas under the curve were 0.839 and 0.833,respectively.psTg<8.935 μg/L patients achieved ER after 3-9 months of follow-up in DTC patients(67/74,90.5%).psTg>8.935 μg/L patients achieved ER(13/42,30.95%).Correspondingly TTR<125.72 ng/mIU achieved ER(65/72,90.2%).psTg>125.72 ng/mIU achieved ER(15/44,34.1%).CONCLUSION:The efficacy of the first 131Ⅰ treatment after surgery for differentiated thyroid cancer is significant.psTg and TTR are independent risk factors for the first 131Ⅰ treatment after DTC and have an important predictive value of efficacy.