分化型甲状腺癌治疗后TgAb变化趋势及其影响因素

目的 探讨分化型甲状腺癌(DTC)中甲状腺球蛋白抗体(TgAb)阳性(＞115 U/ml)患者在手术及¹³¹I治疗后TgAb的变化趋势及其影响因素。方法 纳入118例TgAb阳性患者,分析其手术前、¹³¹I治疗前、¹³¹I治疗后中位随访2.3个月及5.2个月相应时间点TgAb的变化。采用多元线性回归(MLR)观察患者¹³¹I治疗后TgAb下降＞50%所需时间(T₅₀)的影响因素。结果 与前一时间点的TgAb相比,经手术、¹³¹I治疗后中位随访2.3个月和5.2个月TgAb均明显下降(P均=0.000),各阶段降幅＞50%者分别占28.6%、33.3%和37.2%,TgAb转阴率分别为23.4%、48.9%和62.8%。MLR显示,T₅₀仅与¹³¹I治疗距手术时间(B=1.125,P=0.000)有关。结论 手术及¹³¹I治疗可明显降低TgAb阳性DTC患者的TgAb水平。¹³¹I治疗距手术时间对TgAb下降速度有显著影响,术后尽快行¹³¹I治疗有助于TgAb的下降。

Changes in Thyroglobulin Antibodies after Treatment of Differentiated Thyroid Cancer and Its Influencing Factors

Objective To investigate the changes in thyroglobulin antibodies(TgAb)and its influencing factors in differentiated thyroid cancer(DTC)patients with positive TgAb(＞115 U/ml)after total thyroidectomy and radioiodine(¹³¹I)therapy. Methods We collected the clinical data of 118 DTC patients with positive TgAb and analyzed their TgAb levels before surgery,before ¹³¹I therapy,and after ¹³¹I therapy with a median follow-up of 2.3 months and 5.2 months. Multiple linear regression(MLR)was applied to analyze the time of TgAb concentration decreased by more than 50%(T₅₀)and its influencing factors. Results Compared with the previous TgAb levels,TgAb decreased significantly 2.3 months and 5.2 months after surgery or after ¹³¹I therapy,respectively(both P=0.000). The proportions of patients with TgAb decreased by more than 50% in each stage were 28.6%,33.3%,and 37.2%,respectively. The negative conversion ratios were 23.4%,48.9%,and 62.8%,respectively. MLR showed that only the interval between surgery and ¹³¹I therapy was correlated with T₅₀(B=1.125,P=0.000). Conclusions The TgAb levels in DTC patients remarkably decrease after surgery and after ¹³¹I therapy. The interval between surgery and ¹³¹I therapy remarkably influences the lowering speed of TgAb levels. Prompt application of ¹³¹I therapy after surgery helps to lower TgAb levels.