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.

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.

Objective To compare dose distribution in gamma knife radiotherapy plan, conformal radiotherapy(CRT)plan and intensity modulated radiotherapy(MRT)plan for patients with small mass in lung, and evaluate their characters. Methods Fourteen patients with small mass in lung participated in the study. Gamma knife radiotherapy plan(plan 1), CRT plan(plan 2)and IMRT plan(plan 3)were made for each mass. The planning target volume(PTV)and the dose include 95% PTV were consistent.Conformal index(CI), homogeneity index(HI), lung V5 ,V10 ,V20 ,V30 and the max dose of esophagus and spinal cord were analyzed. Paired samples t-test was used for comparison between each two plans. Results The CI of the plan 1,2 and 3 were 0. 58,0. 46 and 0. 63, respectively. CI of the plan 1 ＞ that of the plan 2 (t= -3.95,P =0.000),plan 3 ＞ plan 2(t = -6.01 ,P =0.000),plan 1 =plan 3(t =1.64,P =0.116);HI of the plan 1,2 and 3 were 1.66,1.10 and 1.07 respectively. HI of the plan 1 ＞ plan 2 ,plan 1 ＞ plan 3(t= -20.52,21.41 respectively, both P=0. 000),plan 2 = plan 3(t= -1.08,P=0.294). The wholelung V5 ,V10 ,V20 and V30 were 10.0% ,5.6% ,2. 4% and 1.2%, respectively, in plan 1 ;20. 2% ,13. 4%,6. 9% ,3.0%, respectively, in plan 3; and 26. 5%, 18. 0%, 11.4% and 4. 6%, respectively, in plan 2.The V5, V10, V20 and V 30 of the plan 1 ＜ in plan 2(t = 9. 68,8. 41,5. 45,5. 14, all P = 0. 000), the V5,V10,V20 and V30 of the plan 1 ＜ in plan 3(t=7.58,8.95,6. 15,4.78, respectively, all P=0.000),the V5 ,V10, V20andV30 oftheplan2 ＞ inplan3(t =9. 71,5. 91,4. 13,3.91, respectively, allP =0.000).The max dose of esophagus in plan 1 ,2 and 3 were 24.93 ± 21.54, 31.90 ± 18. 75, 29. 19 ± 23.09 Gy,respectively, plan 1 ＜ plan 2(t = -2. 71 ,P=0.013),plan 1 = plan 3(t = - 1.49,P =0. 152),plan 2 =plan 3(t = 1.35, P = 0. 193). The max dose of spinal cord in plan 1,2 and 3 were 12.07 ± 10. 67,17.70 ±11.35 and 8.92 :± 10. 04 Gy, respectively, plan 2 ＞ plan 1 ＞plan 3(t = -2. 38,2. 29,4. 83,P=0. 1027,0.033,0.000);All three plans of each mass meet the needs that the max dose of the esophagus≤60 Gy and the max dose of spinal cord ≤40 Gy. Conclusions The dose of the normal lung was lower, but the HI and the max dose of spinal cord were higher in Gamma knife radiotherapy plan than those in the CRT and the IMRT plan of the small mass in lung.