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21.
Objective 131Ⅰ is the most effective treatment for thyroidal remnant ablation after thy-roidectomy in patients with differentiated thyroid carcinoma (DTC). Ways to improve its therapeutic efficacy have been a major clinical concern. This study was designed to assess the efficacy of thyroid ablation by finding out its leading factors. Methods Eighty cases of post-operative DTC patients who had undergone first 131Ⅰ remnant ablation therapy were retrospectively reviewed. The efficacy of the therapy was assessed by a diagnostic 131Ⅰ whole body follow-up scan 3- 6 months later. The ablation therapy was considered to be suc-cessful only if no conceivable radioactivity was detected in the thyroidectomy bed. The χ2 test and multi-vari-ance Binary Logistic regression were used to analyze 9 variances which might affect the therapeutic efficacy, including gender, age (<45 years and ≥45 years), type of pathology (papillary or follicular carcinoma), metastasis, residual thyroid weight (low, median, high), 24 h radioiodine uptake ratio (< 10%, 10%-20%, >20%), thyroglobulin (Tg, negative or positive), thyroid stimulating hormone (TSH, <30 mU/L, 30-60 mU/L, >60 mU/L), and radioiodine dose (<1850 MBq,1850-3700 MBq, >3700 MBq). Results 131Ⅰ remnant ablation therapy was successful in 58 of 80 DTC patients (72.5%). Three variances were found to have affected the therapeutic efficacy: residual thyroid weight, 24 h radioiodine uptake ratio and 131Ⅰ dose. The corresponding intra-groups statistical difference of those 3 variances was significant by χ2 test (χ2 = 8.892, 9.528, 15.085, P = 0.012, 0.009, 0. 001), while the intra-group statistical differences of the remaining variances were insignificant (χ2 =0.486, 0. 051, 0. 322, 0. 010, 0. 006, 2. 575, all P > 0. 05). All 9 variances were analyzed by the multi-variance Binary Logistic regression model through for-ward stepwise. The variance of residual thyroid weight (X1) and 131Ⅰ dose (X2) were finally selected as the 2 key parameters in the formula, P=e(-0.865-0.868X1+1.677X2)/[1-e(-0.865-0.868X1+1.677X2)] , by the Binary Logistic regression analysis (Wald values were 3.752 and9. 130, P=0.049, 0.003). Conclusions The efficacy of 131Ⅰ ablation of thyroidal remnant in post-operative DTC patients was mainly determined by the re-sidual thyroid weight and the therapeutic 131Ⅰ dose. The other 7 factors included in this study were not found to be statistically significant. 相似文献
22.
目的 :评价血清HTg和 13 1I全身显像联合检查对分化型甲状腺癌 (differentiat edthyvoidcarcinoma ,DTC)患者 13 1I治疗后随访的临床意义。方法 :85例DTC患者停服甲状腺激素 4~ 6周并忌碘饮食 3 0d后 ,双抗体法测定血清HTg ,同时口服 13 1I 185~3 70MBq 2 4h后 ,和 (或 )口服治疗剂量 13 1I 4~ 7d后做全身显像。结果 :61例经临床证实有复发或转移的DTC患者中 ,3 8例(62 3 0 % )HTg高于正常 ,有肺或 (和 )骨转移者 ,血清HTg升高更加明显 ,极端甚至 >2 0 0 μg/L。2 2例肺转移及肺 (骨 )转移患者 ,其血清HTg水平随 13 1I治疗剂量的增加而呈降低趋势。 5 3例 (86 88% ) 13 1I全身显像结果和 (或 )血清HTg有阳性表现 ,只有49 18% (3 0 /61)的患者同时出现 13 1I全身显像有异常浓聚和血清HTg异常升高。 结论 :DTC术后及 13 1I治疗后 ,常规进行血清HTg测定和 13 1I全身显像检查 ,对早期发现复发或有无转移灶、13 1I治疗方案的选择以及评估 13 1I疗效具有重要的临床价值。 相似文献
23.
Objective 131Ⅰ is the most effective treatment for thyroidal remnant ablation after thy-roidectomy in patients with differentiated thyroid carcinoma (DTC). Ways to improve its therapeutic efficacy have been a major clinical concern. This study was designed to assess the efficacy of thyroid ablation by finding out its leading factors. Methods Eighty cases of post-operative DTC patients who had undergone first 131Ⅰ remnant ablation therapy were retrospectively reviewed. The efficacy of the therapy was assessed by a diagnostic 131Ⅰ whole body follow-up scan 3- 6 months later. The ablation therapy was considered to be suc-cessful only if no conceivable radioactivity was detected in the thyroidectomy bed. The χ2 test and multi-vari-ance Binary Logistic regression were used to analyze 9 variances which might affect the therapeutic efficacy, including gender, age (<45 years and ≥45 years), type of pathology (papillary or follicular carcinoma), metastasis, residual thyroid weight (low, median, high), 24 h radioiodine uptake ratio (< 10%, 10%-20%, >20%), thyroglobulin (Tg, negative or positive), thyroid stimulating hormone (TSH, <30 mU/L, 30-60 mU/L, >60 mU/L), and radioiodine dose (<1850 MBq,1850-3700 MBq, >3700 MBq). Results 131Ⅰ remnant ablation therapy was successful in 58 of 80 DTC patients (72.5%). Three variances were found to have affected the therapeutic efficacy: residual thyroid weight, 24 h radioiodine uptake ratio and 131Ⅰ dose. The corresponding intra-groups statistical difference of those 3 variances was significant by χ2 test (χ2 = 8.892, 9.528, 15.085, P = 0.012, 0.009, 0. 001), while the intra-group statistical differences of the remaining variances were insignificant (χ2 =0.486, 0. 051, 0. 322, 0. 010, 0. 006, 2. 575, all P > 0. 05). All 9 variances were analyzed by the multi-variance Binary Logistic regression model through for-ward stepwise. The variance of residual thyroid weight (X1) and 131Ⅰ dose (X2) were finally selected as the 2 key parameters in the formula, P=e(-0.865-0.868X1+1.677X2)/[1-e(-0.865-0.868X1+1.677X2)] , by the Binary Logistic regression analysis (Wald values were 3.752 and9. 130, P=0.049, 0.003). Conclusions The efficacy of 131Ⅰ ablation of thyroidal remnant in post-operative DTC patients was mainly determined by the re-sidual thyroid weight and the therapeutic 131Ⅰ dose. The other 7 factors included in this study were not found to be statistically significant. 相似文献
24.
脂肪吸收不良是常见的病症,但确诊较困难.胆盐缺乏、小肠粘膜受损及胰腺外分泌功能不全均可导致脂肪吸收不良,相互鉴别更是不易.用无创伤性、无放射性的~(13)CO_2呼气试验不但能简便、可靠地诊断脂肪吸收不良,而且还能有效地作出胰源性与胰外性脂肪吸收不良的鉴别诊断. 相似文献
25.
吴靖川 《上海交通大学学报(医学版)》2005,25(12)
该文综述了正电子、单光子核素肿瘤示踪剂的发展、肿瘤细胞摄取的分子学基础以及今后的研究方向.随着正电子核素标记物的广泛应用,对价格低、适应我国国情的符合电路SPECT和高档次PET/CT的发展作了比较.在临床应用中,重点介绍18F-FDG显像在甲状腺癌、肺癌、淋巴瘤以及乳腺癌的早期诊断、分期、疗效、预后以及在今后放射治疗中的应用. 相似文献
26.
目的 探讨重组真核表达质粒pcDNA3.1/人TSH受体(hTSHR)体外转染TSHR表达下降的低分化滤泡状甲状腺癌细胞株后,细胞摄取放射性碘功能以及甲状腺癌相关基因mRNA表达 的变化.方法 pcDNA3.1/hTSHR转化DH5a感受态菌,进行扩增、酶切,再以核苷酸测序方法鉴定.体外转染pcDNA3.1/hTSHR,通过免疫荧光检测TSHR表达产物,井型γ计数仪检测摄碘率,相对定量实时荧光PCR验证其表达的TSHR蛋白功能和特性.采用SPSS 13.0软件,对计量资料行t检验.结果pcDNA3.1/hTSHR经PCR扩增hTSHR-cDNA片段约113 kb,Kpn Ⅰ和Xha Ⅰ双酶切:hTSHR-cDNA的片段约2.3 kb,pcDNA3.1(+)的片段约5.5 kb,均同预期片段大小相符;核苷酸测序方法鉴定测序结果与GenBank中收录的hTSHR全长序列一致,表明真核表达质粒构建正确.在hTSH刺激下,转染pcDNA3.1/hTSHR细胞与转染pcDNA3.1(+)细胞比较:(1)在甲状腺肿瘤细胞胞质、胞膜有增强的绿色荧光,(2)前者125 I摄取率是后者的2.9倍(t=28.63,P<0.01),(3)甲状腺碘摄取相关基因TSHR、钠碘转运体(NIS)、甲状腺过氧化物酶(TPO)、Tg的mRNA的表达分别升高1.74倍(t=5.959,P<0.01)、7.2倍(t=3.807,P<0.05)、2.88倍(t=4.769,P<0.01)和2.67倍(t=6.388,P<0.01).结论 pcDNA3.1/hTSHR体外转染甲状腺癌肿瘤细胞后,可有效提高碘的摄取;这可为放射性碘治疗失分化甲状腺癌提供新的实验依据. 相似文献
27.
28.
光剥舌患者总体蛋白更新速度及其临床意义 总被引:4,自引:0,他引:4
目的 :了解光剥舌患者蛋白质代谢变化的总体特征。方法 :用稳定同位素15N标记的氨基酸作示踪剂 ,测定 30例光剥舌苔患者和 15例正常人总体蛋白更新速度。结果 :光剥舌苔患者总体蛋白质代谢速率加快 ,分解速率大于合成速率 (P <0 .0 1) ,蛋白质代谢处于负平衡。结论 :光剥舌患者蛋白质代谢的变化可能与体内交感神经活动的变化有关。在临床治疗除要提供高能量、富含必需氨基酸、蛋白质的饮食、药物及维生素B6以外 ,更应抓紧治疗原发病及补肾养阴治疗 相似文献
29.
目的 探讨提高分化型甲状腺癌(DTC)复发灶或转移灶检出率的最优化核素显像方法 .方法 对89例DTC患者的临床资料进行回顾性分析.核素显像方法 包括血清甲状腺球蛋白(Tg)检查结合放射性碘(131Ⅰ)治疗剂量全身显像、99mTc-MIBI肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像,对三种核素显像的结果 进行对比分析.结果 131Ⅰ治疗剂量全身显像、99mTc-MIBI 肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像的灵敏度分别为83.05%、79.66%和16.95%.结论 99mTc-MIBI肿瘤显像和18F-FDG带符合线路的SPECT/CT全身显像作为补充检查手段,可弥补血清Tg检查结合131Ⅰ全身显像的局限性,对DTC患者复发灶或转移灶的检出、疗效评估及进一步治疗方案的制定具有重要意义. 相似文献
30.
目的:探讨胃癌组织β-catenin(β-cat)和P53蛋白异常表达与螺旋CT征象异常的关系。方法:采用免疫组化法(两步法)检测胃癌手术切除的109例标本中β-cat和P53蛋白的表达。结果:胃癌β-cat阳性表达率为56.9%(62/109),且阳性表达与螺旋CT提示的淋巴结转移相关(P 相似文献