~(131)I标记槲皮素治疗失分化及未分化甲状腺癌的可行性

<正>甲状腺癌(DTC)是内分泌系统恶性肿瘤,按病理类型可分为乳头状癌(PTC,占70%⁷5%)、滤泡状癌(FTC,占15%75%)、滤泡状癌(FTC,占15%²0%)未分化癌(ATC,占3%20%)未分化癌(ATC,占3%⁵%)、髓样癌(MTC,占1%5%)、髓样癌(MTC,占1%³%)〔1〕。近几十年来,DTC成为了发病率最快的实体肿瘤〔2〕。DTC采取手术治疗+131I治疗+促甲状腺激素(TSH)治疗是国际公认的治疗三部曲,其预后效果较好,存活率高。131I是治疗DTC最特异、最有效的放射性药物,可以被甲状腺组织高选择性的吸收,疗效确切。131I核素治疗的基础是癌灶或转移灶具有     

~(131)I治疗甲状腺功能亢进后并发白血病1例

患者,男,15岁。因发现白细胞减低2个月入院。患者1995年被诊断为Graves病,后长期用抗甲状腺药物治疗,并定期随诊。药物治疗5年中,甲状腺功能亢进(甲亢)症状控制良好,血常规检测正常。患者于2000年7月甲亢复发,调整用药后至2001年8月仍未能控制,且症状加重。于是改用核素131I治疗,同年10月口服131I222MBq。半年后甲亢症状改善,白细胞最低至4.2×109/L,再予药物控制。2002年12月甲亢症状又复加重,再次于2003年2月口服131I370MBq。同年底发现白细胞降至2.3×109/L,于当地医院行升白细胞治疗,效果不佳遂来我院进一步诊治。入院体检:体温37.4…     

~(131)I与碳酸锂联合治疗重度甲状腺肿伴甲状腺功能亢进的临床观察

重度甲状腺肿伴甲状腺功能亢进(甲亢)病人131I治疗的一次性治愈率较低,笔者采用131I联合碳酸锂治疗,收到了良好的治疗效果,现报道如下。1资料与方法1.1观察对象:重度甲状腺肿伴甲亢病人68例,男20例,女48例,年龄25￣56岁,平均41.5岁。甲状腺质量65￣120g。所有病人FT3、FT4水平增高,甲状腺微粒体抗体(TMAb)及甲状腺球蛋白抗体(TGAb)阴性,均可排除桥本氏病的情况。将患者随机分成2个组,131I组和131I联合碳酸锂组,每组34人,两组间性别、年龄、甲状腺激素水平及甲状腺重量差异均无统计学意义。1.2治疗方法:所有病人停服抗甲状腺药物1周后…     

~(131)I标记槲皮素对未分化型甲状腺癌的辐射增敏作用

目的探讨~(131)I标记槲皮素对未分化型甲状腺癌的辐射增敏作用。方法利用细胞生长抑制实验观察~(131)I-槲皮素对裸鼠种植甲状腺癌的治疗效果,应用免疫荧光显微镜观察γ-H2AX变化。结果三种药物对DRO增殖的抑制强弱顺序为~(131)I-QU>QU>~(131)I且抑制作用与药物剂量及作用时间均呈依赖关系。与对照组相比,注射药物后治疗组肿瘤体积被明显抑制,从第3天开始,治疗组与对照组肿瘤体积有显著性差异(P<0.05),第28天的抑瘤率约为66.51%。免疫荧光显微镜测试显示槲皮素会影响γ-H2AX集落形成。结论体外和体内的研究表明~(131)I标记槲皮素能增强~(131)I的内放疗敏感性,细胞用槲皮素预处理后显著增加了γ-H2AX的持续时间。     

吉林地区甲状腺摄~(131)碘率的研究

测1360例24小时甲状腺摄碘率,服用碘盐病区男性均值为21.21%(范围3.57—38.85%),女性均值为23.57%(范围3.44—43.7%);而未服碘盐的非病区男性均值为32.3%(范围11.19—53.41%),女性均值为39.42%(范围14.37—64.47%)。病区低于非病区。服碘盐前病区24小时摄碘率为44%,尿碘为30.5μg/克肌酐。投碘盐后尿碘升为148.37μg/克肌酐,摄碘率则明显下降,其原因与补碘有关。     

老年甲亢伴肝损害的~(131)I治疗分析

目的 评价分析~(131)I治疗在老年甲亢伴肝损害中的应用价值及其影响因素.方法 172例老年甲亢伴肝损害患者,依据甲状腺激素测定、甲状腺吸碘率、甲状腺静态显像等,计划剂量为每克有功能甲状腺组织2.59～4.44 MBq,行~(131)I治疗.治疗后3、12个月复查甲功及肝功,以评价治疗效果.结果 甲亢治愈率为72.67%,多数肝损害在甲亢治愈后恢复正常.结论 老年甲亢伴肝损害患者治疗应首选~(131)I治疗.     

~(131)I治疗是Graves病根治的有效方法

131I治疗Graves病工作已有近70年的历史,在欧美目前已成为治疗Graves病主流治疗方法,它具有方法简单、治愈率高等优点。131I治疗的适应证近年来有明显的改变,成人Graves病是主要适应证,当Graves病伴有心脏病、白细胞减低、肝损害等并发症时131I治疗是理想的治疗方法。欧美等国131I治疗Graves病的临床治愈率接近100%,甲减发生率在50%以上。131I治疗后出现的甲减,现在认为是治疗后的转归,不可避免。近70年的循证医学资料证实131I治疗Graves病不造成恶性肿瘤、白血病等肿瘤的发生,对遗传和生育没有影响。     

~(131)I治疗甲亢并发白血病1例

患者 ,男 ,3 1岁。因乏力、进行性面色苍白、衰弱、不规则发热 2个月余 ,于 2 0 0 1年 1 2月 1 7日入院。患者已患甲亢 4年 ,经他巴唑、甲亢平等药治疗 ,效果不佳。于 2 0 0 0年 6月、1 2月两次在我院内分泌科行1 31 Ｉ治疗 ,剂量分别为 44.4× 1 0 1 0 ｍＢｑ和 3 7× 1 0 1 0 ｍＢｑ,治疗后半年甲亢症状消失 ,住院期间化验血常规、Ｂ超检查无异常 ,但近 2个月余出现上述症状。入院体检 :Ｔ 3 8℃ ,贫血貌 ,眼睑、指 (趾 )甲苍白 ,皮肤、粘膜无出血点 ,双颈部、腋窝、腹股沟可扪及 0 .5ｃｍ～ 1 .5ｃｍ多个淋巴结 ,移动、无压痛 ,胸骨压痛 …     

同位素~(131)Ⅰ测定56例慢性布鲁氏菌病患者毛细血管通透性的观察

用放射性同位素~(131)I测定56例慢性布病患者毛细血管通透性,其中有41.7％的病人毛细血管通透性增高,皮肤储存点平均半量吸收时间为11.71±3.58分钟,明显高于健康对照组(8.45±1.93分钟)。在重型病人中有60％患者毛细血管通透性增强,皮肤储存点平均半量吸收时间为13.16±2.41分钟,均明显高于轻型病人组(25.8％和10.20±2.62分钟)。     

~(131)I治疗老年分化型甲状腺癌的疗效

目的评价131I治疗老年分化型甲状腺癌(DTC)的治疗效果及应用价值。方法回顾性分析了96例老年DTC根治术后131I治疗效果,根据手术病理、甲状腺吸碘率、Tg、TgAb、肺CT、颈部彩超等因素,采用相对固定剂量法,清甲治疗给予131 I 2.96～4.44 GBq,清灶治疗给予131 I5.55～7.40 GBq,并给予甲状腺激素替代-抑制治疗。随访18～36个月评价疗效。结果 96例131 I治疗老年DTC后,36例治愈,50例有效,10例无效。结论老年DTC不同于中青年DTC,发现晚、预后较差。根治术术后1～2个月行131I清甲成功率较高,明显改善预后,提高生存质量,故老年DTC根治术后行131I内照射治疗具有重要的临床价值。     

Imaging of experimental amyloidosis with 131I-labeled serum amyloid P component

131I-labeled human serum amyloid P component, which was injected into mice with experimentally induced systemic AA amyloidosis and into controls, became specifically localized and was retained in amyloidotic organs. In comparison, it was rapidly and completely eliminated from unaffected tissues and from control animals. Distinctive images of this amyloid-specific deposition of labeled serum amyloid P component were derived from whole body scanning, in vivo, of amyloidotic mice. These findings suggest that such imaging may have applications for the diagnosis and quantitation of amyloid deposits in humans.     

Direct in vivo injection of ~(131)I-GMS and its distribution and excretion in rabbit

AIM: To explore the distribution and metabolism of 131 I-gelatin microspheres ( 131 I-GMSs) in rabbits after direct injection into rabbits’ livers.METHODS: Twenty-eight healthy New Zealand rabbits were divided into seven groups,with four rabbits per group.Each rabbit’s hepatic lobes were directly injected with 41.336 ± 5.106 MBq 131 I-GMSs.Each day after 131 I-GMSs administration,4 rabbits were randomly selected,and 250 μL of serum was collected for γ count.Hepatic and thyroid functions were tested on days ...     

Evaluation of therapeutic effectiveness of ~(131)I-antiEGFR-BSA-PCL in a mouse model of colorectal cancer

AIM: To investigate the biological effects of internal irradiation, and the therapeutic effectiveness was assessed of ~(131)I-labeled anti-epidermal growth factor receptor(EGFR) liposomes, derived from cetuximab, when used as a tumor-targeting carrier in a colorectal cancer mouse model.METHODS: We described the liposomes and characterized their EGFR-targeted binding and cellular uptake in EGFR-overexpressing LS180 colorectal cancer cells. After intra-tumor injections of 74 MBq(740 MBq/m L) ~(131)I-anti EGFR-BSA-PCL, we investigated the biological effects of internal irradiation and the therapeutic efficacy of ~(131)I-anti EGFR-BSA-PCL on colorectal cancer in a male BALB/c mouse model. Tumor size, body weight, histopathology, and SPECT imaging were monitored for 33 d post-therapy.RESULTS: The rapid radioiodine uptake of ~(131)I-antiEGFR-BSA-PCL and ~(131)I-BSA-PCL reached maximum levels at 4 h after incubation, and the ~(131)I uptake of ~(131)I-anti EGFR-BSA-PCL was higher than that of ~(131)I-BSAPCL in vitro. The ~(131)I tissue distribution assay revealed that ~(131)I-anti EGFR-BSA-PCL was markedly taken up by the tumor. Furthermore, a tissue distribution assay revealed that ~(131)I-anti EGFR-BSA-PCL was markedly taken up by the tumor and reached its maximal uptake value of 21.0 ± 1.01 %ID/g(%ID/g is the percentage injected dose per gram of tissue) at 72 h following therapy; the drug concentration in the tumor was higher than that in the liver, heart, colon, or spleen. Tumor size measurements showed that tumor development was significantly inhibited by treatments with ~(131)I-anti EGFR-BSA-PCL and ~(131)I-BSA-PCL. The volume of tumor increased, and treatment rate with ~(131)I-anti EGFR-BSA-PCL was 124% ± 7%, lower than that with ~(131)I-BSA-PCL(127% ± 9%), ~(131)I(143% ± 7%), and normal saline(146% ± 10%). The percentage losses in original body weights were 39% ± 3%, 41% ± 4%, 49% ± 5%, and 55% ± 13%, respectively. The best survival and cure rates were obtained in the group treated with ~(131)I-anti EGFR-BSA-PCL. The animals injected with ~(131)I-anti EGFR-BSA-PCL and ~(131)I-BSA-PCL showed more uniform focused liposome distribution within the tumor area.CONCLUSION: This study demonstrated the potential beneficial application of ~(131)I-anti EGFR-BSA-PCL for treating colorectal cancer. ~(131)I-anti EGFR-BSA-PCL suppressed the development of xenografted colorectal cancer in nude mice, thereby providing a novel candidate for receptor-mediated targeted radiotherapy.     

131I与抗甲状腺药物治疗甲亢性心脏病临床疗效比较

目的: 比较131I与抗甲状腺药物（ATD）治疗甲亢性心脏病的临床疗效。方法: 对226例甲亢性心脏病患者分别采用131I（151例）及ATD（75例）治疗,比较两组病例的临床疗效、治疗前后甲状腺激素水平、心电图及超声心动图变化情况。结果: 131I组的总有效率显著高于ATD组（P<0.01);且心功能改善及心电图好转率均显著高于ATD组（均P<0.01)。超声心动图检查:131I组患者LVEF、LVEDD、LVESD、SV及CO治疗后较治疗前显著改善(P<0.01);ATD组治疗前后差异无统计学意义;治疗后两组指标相比差异有统计学意义（P<0.01)。两组治疗后甲状腺激素水平较治疗前均显著降低（P<0.01),但两组治疗后甲状腺激素水平相比无统计学意义。131I组甲状腺功能减退（甲减）发生率显著高于ATD组（17% vs. 0%,P<0.01）。结论: 131I治疗甲亢性心脏病综合疗效优于ATD,缺点是甲减发生率高。     

抗甲状腺药物对~(131)I治疗甲状腺功能亢进症疗效的影响

131I是治疗甲状腺功能亢进症(甲亢)的主要药物之一,治疗前应用硫氧嘧啶类药物如丙硫氧嘧啶可能会降低131I治疗甲亢的治愈率,咪唑类药物如甲巯咪唑则不会影响其疗效。131I治疗甲亢后应用丙硫氧嘧啶或甲巯咪唑对131I疗效的影响尚有争议之处。抗甲状腺药物影响131I疗效的机理可能在于改变了131I的有效半衰期和(或)甲状腺对131I的摄取率。     

小剂量~(131)碘治疗儿童Graves病42例疗效观察

目的　探讨小剂量 1 31 碘 (1 31 I)治疗儿童 Graves病的疗效。方法　 1 31 I剂量降至常规计算用量的 1/2～ 2 /3,1次顿服 ,3个月为 1个疗程 ,进行疗效复查 ,总剂量 37～ 185 MBq。结果　 4 2例患儿中 ,痊愈 38例 ,治愈率为 90 .5 % ;显效 2例 ,占 4 .8% ;无效 1例 ,占 2 .4 % ;1例出现早发甲状腺功能低下 (甲低 ) ,经治疗后恢复。治愈总疗程 1～ 3个 ,时间 3～ 9个月。痊愈病例中 ,服药 1个疗程治愈 17人 (44 .8% ) ,2个疗程治愈 16人 (42 .1% ) ,3个疗程治愈 5人 (13.1% ) ,观察 3～ 5年 ,38例治愈患者中未出现甲状腺功能亢进症复发或晚发甲低。结论　小剂量 1 31 I是治疗儿童 Graves病安全、有效的方法。     

Dosimetry of 131I-labeled antiferritin in hepatoma: specific activities in the tumor and liver

Dosimetric studies are reported for 22 patients with hepatoma who received treatment with 131I-labeled antiferritin IgG. Studies included liver and tumor volume computations based on computerized axial tomographic scan analysis, in-vivo quantitation of the activity deposited in hepatic tumors and normal liver tissue, and effective half-life measurements of the activity in the tumor, liver, and total body. Administered activities of polyclonal and affinity-column purified 131I-labeled antiferritin IgG ranged from 32 to 157 mCi. Tumor volumes at the time of radioimmunoglobulin infusion ranged from 220 to 3020 cm3 and total liver volumes ranged from 900 to 4620 cm3. For tumor volumes ranging from 220 to 1700 cm3, the maximum tumor activity was linearly proportional to tumor volume, but independent of antiferritin preparations and administered activities. In this range of tumor volumes, the mean value of tumor-to-liver ratios of specific activities was 4.8:1. Hepatomas ranging from 2290 to 3020 cm3 had reduced tumor uptake of radiolabeled antiferritin IgG and had a tumor-to-liver ratio of specific activities of 1.6:1. For all patients studied there was a linear relationship between the volume of normal liver tissue and the maximum activity deposited. These data, in conjunction with toxicity studies and tumor effective half-life measurements, led to the present treatment regimen of administering 30 mCi of polyclonal antiferritin IgG on Day 0 and 20 mCi on Day 5 following the first injection. This has resulted in the same range of absorbed dose to the tumor as was achieved with larger administered activities, but with a significant reduction of total-body irradiation to the patient.