131I治疗老年与非老年分化型甲状腺癌淋巴结转移的临床观察

目的探讨老年分化型甲状腺癌淋巴结转移（LMDTC）的临床影响因素及131I治疗效果与非老年LMDTC的差异。方法对38例LMDTC患者,用B超、CT、131I显像及Tg变化判断131I治疗效果差异。结果老年组与非老年组LMDTC比较：淋巴结大小（P=0.0452）及合并远处转移（P=0.0126）两组差异有统计学意义;131I治疗有效率老年组为64.7%（11/17）,非老年组为95.2%（20/21）,两组差异有统计学意义（P〈0.05）。随访期内未出现131I治疗引起造血系统抑制、慢性涎腺炎和继发肿瘤的发生。结论老年组与非老年LMDTC的临床影响因素有差异,131I治疗效果不及非老年组,但仍是有效且安全的治疗方法。

Clinical Observation of 131I Therapy for Lymph Node Metastases from Differentiated Thyroid Cancer in the Elderly Versus Non-elderly Patients

Objective To explore the difference of the main clinical influence factors and 131I therapeutic effect between the elderly and non-elderly patients with lymph node metastases from differentiated thyroid cancer （LMDTC）. Methods The clinical influence factors in 38 patients with LMDTC were retrospectively analyzed. The difference of 131I therapeutic effect was assessed comprehensively by detection of neck ultrasonography and CT,whole body scan with 131I and changes of serum Tg level in elderly and non-elderly patient groups. Results There were significant differences in the size of lymph node and the incidence of metastases between the two groups （P 〈0.05）. The total effective rate of 131I therapy were 64.7% and 95.2% in the elderly group and the non-elderly group respectively （ P 〈 0.05 ）. No secondary tumors caused by 131I therapy were found hemopoietic system damage, chronic sialadenitis and in the follow-up period. Conclusion There are some differences in the main clinical influence factors between two groups, and prominent in the elderly group than that in non-elderly group, but 131I therapy elderly patients with LMDTC. 131I therapeutic effect is less is still effective and safe for the