放射性碘对大鼠致癌效应的研究

对雄性Wisiaf大鼠腹腔1次注射碘-13l, 注入活度分别为0.59×10⁴Bq,2.37×10⁴Bq, 4.34×10⁴Bq, 8.23×10⁴Bq, 碘-125注入活度分别为3.7×10⁴Bq, 7.4×10⁴Bq, 14.8×10⁴Bq, 22.2×10⁴Bq.碘-131诱发肿痛实际注入活度在2.37×10⁴Bq以下,碘-125的为7.4×10⁴以下.诱发的肿瘤以甲状腺肿瘤为主,其次为垂体肿瘤.     

131I与抗甲状腺药物治疗儿童和青少年Graves病的疗效比较

目的评价131I与抗甲状腺药物（ATD）治疗儿童和青少年Graves病的疗效。方法取7～16岁儿童和青少年Graves病患者15例,分为131I治疗组8例和ATD治疗组7例,随访2年,观察131I与ATD治疗后疗效、突眼发生率、甲状腺功能低下（甲低）发生率、甲亢复发率及不良反应的情况。结果 131I组治愈6例（6/8）,好转1例（1/8）,无效1例（1/8）;ATD组治愈3例（3/7）,好转2例（2/7）,无效2例（2/7）,两组疗效比较,131I组明显高于ATD组（P〈0.01）。治疗后在甲低的发生率131I组高于ATD组（P〈0.01）;甲亢复发率131I组低于ATD组（P〈0.01）;发生突眼和对突眼改善的疗效上差异无统计学意义（P〉0.01）;出现甲亢性心脏病、肝功能受损、白细胞降低等不良反应方面131I组低于ATD组（P〈0.01）。结论 131I治疗儿童和青少年Graves病综合疗效优于ATD,是一种疗效肯定、比较安全的方法 。     

131I囊内照射治疗甲状腺囊肿的临床研究

目的探讨131I内照射治疗甲状腺囊肿的疗效及影响因素.方法穿刺抽出甲状腺囊肿内容物后,将一定活度的131I注入囊腔内,依据囊肿直径的变化评价疗效.结果 131I囊内注射治疗甲状腺囊肿的治愈率为68.2%,总有效率为93.2%.结论 131I囊内注射治疗甲状腺囊肿疗效确切,可以作为治疗甲状腺囊肿的一种新方法.     

THE SIGNIFICANCE OF RADIOIMMUNOIMAGING IN THE MANAGEMENT OF CANCER PATIENTS

ＴＨＥＳＩＧＮＩＦＩＣＡＮＣＥＯＦＲＡＤＩＯＩＭＭＵＮＯＩＭＡＧＩＮＧＩＮＴＨＥＭＡＮＡＧＥＭＥＮＴＯＦＣＡＮＣＥＲＰＡＴＩＥＮＴＳＬｉｎＢａｏｈｅ林保和；ＹａｎｇＺｈｉ杨志；ＺｈａｎｇＱｉｎｇ张青；ＸｕＸｉａｏｂａｏ许小宝；ＭｕＡｐｉｎｇ牟阿平；Ｄ...     

Stimulated Serum Thyroglobulin Level at the Time of First Dose of Radioactive Iodine Therapy Is the Most Predictive Factor for Therapeutic Failure in Patients With Papillary Thyroid Carcinoma

Purpose

To investigate the clinical importance of serum thyroglobulin (Tg) levels just before high-dose I-131 ablation therapy (preablation Tg) for predicting therapeutic failure in patients with papillary thyroid carcinoma (PTC).

Methods

Patients with PTC (n = 132) undergoing total thyroidectomy followed by the first high-dose I-131 ablation therapy (HI-Rx) were included in this retrospective review. Just before HI-Rx, preablation Tg, anti-Tg antibody, and TSH were measured. The patients were followed up for a mean period of 7 months (range 6–23 months) by I-123 whole-body scans (f/u IWBS) and stimulated Tg (f/u Tg). Therapeutic failure was defined by positive f/u IWBS or f/u Tg >2 ng/ml. We classified patients into three groups according to the value of preablation Tg (group 1, <1 ng/ml; group 2, ≥1 and <10 ng/ml; group 3, ≥10 ng/ml) and compared clinical variables to therapeutic response.

Results

Therapeutic failure was noted in 39 patients (29.5 %). On univariate analysis, T stage, tumor size, and preablation Tg were the statistically significant factors that could predict therapeutic failure. After multivariate analysis, preablation Tg was the only independent predictor of therapeutic failure (P < 0.001). The therapeutic failure rate was significantly increased as the preablation Tg level increased (11.3 %, 33.3 %, and 87.5 % in groups 1, 2, and 3, respectively; P < 0.001). Individuals with preablation Tg levels ≥10 ng/ml had 25.5 times greater chance of therapeutic failure than those with levels <10 ng/ml (95 % CI = 5.43–119.60; P < 0.001).

Conclusions

A high preablation Tg level is the most significant predictor of therapeutic failure at the time of first HI-Rx in patients with PTC.     

术后分化型甲状腺癌131Ⅰ清甲治疗疗效及影响因素分析

目的：探讨手术后分化型甲状腺癌131Ⅰ清甲治疗的临床疗效及影响因素.方法：对376例分化型甲状腺癌患者行131Ⅰ治疗,并进行2-10年随访,以全身131Ⅰ扫描,甲状腺摄131Ⅰ率、血清TG浓度来评判清甲治疗疗效.结果：376例患者中266例1次131Ⅰ消融成功,1次成功率70.74％.1次消融有效病例333例,有效率为88.56％.消融无效病例43例,无效率11.44％.不同病理类型间一次消融率无统计学差异,不同治疗时间一次消融成功率有统计学差异.结论：甲状腺外科手术＋ 131Ⅰ＋ TSH抑制治疗的综合治疗方法在分化型甲状腺癌的治疗中有重要作用,外科手术方式和手术后到131Ⅰ治疗时间是疗效的重要影响因素.     

甲状腺摄碘率对甲亢患者131I疗效影响的研究

目的通过回顾性研究甲状腺摄碘率（RAIU）与有效半衰期（EHL）对甲亢患者131I疗效的影响,探讨131I治疗甲亢的更有效方案。方法收集531例行131I治疗的Graves病患者资料,包括131I疗前的RAIU、EHL检查结果,及定期检测的F13、FT4、sTSH、TRAb等结果。根据RAIU高峰值、高峰时间、EHL不同分别进行分组,观察各组近期预后。结果RAIU高峰值越高,未愈比例越高。高峰值（100～91）％组痊愈比例最低,高峰值（70～51）％组甲减发生比例最高。高峰值出现的越早,未愈比例越高,甲减发生比例越低。EHL最长组痊愈比例最低,未愈比例最高;EHL小于4天组未愈比例也较高。结论RAIU高峰值高于90％或低于70％者,及高峰时间太短或EHL小于4d者,131I疗效较差,需调整131I治疗量。EHL长短与131I疗效不成正比,当EHL大于7d时,不宜因此而减少131I治疗用量。     

经淋巴管输注5-~(131)碘脲嘧啶的实验性研究

30只大白兔,随机分成经兔足淋巴管途径和经兔耳静脉途径注药组,每只兔子注入~(131)碘标记的脲嘧啶46Bq。随机将兔子分成注药后即刻、12 min、36 min、1h48min及5h24min这五个时相组,及时摘取兔右腘窝、右髂、右腰淋巴结,测定其药物放射强度。实验结果显示经淋巴管注药组免腘窝、髂、腰淋巴结内的药物浓度明显高于经静脉注药组,而且药物保持高浓度的时间也明显延长。经过三因素方差分析统计学处理,说明上述两组实验兔淋巴结内的药物浓度及其停留时间,均有极显著差异(p<0.01)。因此,我们推测对于妇科恶性肿瘤患者,在手术前后辅以经淋巴管输注抗肿瘤药物,有可能提高其生存率。在这方面今后准备作进一步的探索。     

Iodine 131 uptake in a pleuropericardial cyst: case report of a false-positive radioiodine total body scan result in a patient with a thyroid cancer

An uptake of iodine 131 was casually discovered in the precordial region of a patient with a thyroid cancer and corresponded to a pleuropericardial cyst. Offprint requests to: M. Schlumberger