非高危分化型甲状腺癌低剂量和高剂量131I清甲疗效的分析

目的 研究应用低剂量（1.11 GBq）和高剂量（3.70 GBq）放射性131I清除非高危分化型甲状腺癌（DTC）术后残留甲状腺组织的疗效。 方法 回顾性分析行131I清甲治疗的63例非高危DTC患者的临床资料，采用Binary Logistic回归分析年龄、首次手术距清甲的时间间隔、甲状腺24 h摄碘率、血清TSH水平和清甲剂量对清甲疗效的影响；27例患者给予低剂量、36例患者给予高剂量的131I清甲治疗，采用Pearsonχ2检验分析低剂量和高剂量131I清甲疗效的差异，P < 0.05表示差异有统计学意义。 结果 63例非高危DTC患者中，清甲成功者46例（73.02%，46/63）、未成功者17例（26.98%，17/63）；Binary Logistic回归分析显示，131I清甲剂量是清甲成功与否的主要影响因素（Wald=6.42，P=0.011）；27例给予低剂量131I清甲患者中有15例清甲成功，36例给予高剂量131I清甲者中31例清甲成功，Pearsonχ2检验结果表明，高剂量131I清甲成功率（86.11%，31/36）明显高于低剂量（55.56%，15/27）（χ2=7.311，P=0.007）。 结论 在临床实践中，当残余甲状腺组织较少时，对于非高危DTC患者可考虑采用高剂量131I清甲治疗，提高一次清甲成功率。

Ablation efficacy in non-high-risk differentiated thyroid carcinoma patients with low-dose and high-dose 131I

Objective To investigate the efficacy of low-dose(1.11 GBq) and high-dose(3.70 GBq) radioactive 131I on residual thyroid tissues in patients after a non-high-risk differentiated thyroid carcinoma (DTC) resection.Methods Clinical data of a total of 63 patients with non-high-risk DTC who had experienced 131I therapy were analyzed retrospectively.Binary logistic regression was employed to analyze the effects of age,interval from initial resection to initial 131I ablation,rate of thyroid iodine uptake for 24 h,serum TSH level,and 131I dose on efficacy of thyroid remnant ablation.Out of 63 patients,27 were given low doses while 36 patients were given high doses of 131I therapy.Pearson's chi-square test was used to differentiate the efficacy of low-dose and high-dose 131I on residual thyroid tissues.P＜0.05 was considered statistically significant.Results Among the 63 non-high-risk DTC patients,46 patients achieved successful thyroid remnant ablation (73.02％,46/63) but 17 failed (26.98％,17/63).Binary logistic regression analysis indicated that the ablation dose of 131I was the main factor for the efficacy of ablation (Wald=6.42,P=0.011).Among the 27 patients who had low doses of 131I therapy,15 achieved effective thyroid remnant ablation.However,31 patients achieved effective thyroid remnant ablation after high doses of 131I therapy among 36 patients.Pearson's chi-square test revealed that the ablation efficacy in patients with high-dose 131I (86.11％,31/36) was higher than those with low-dose 131I(55.56％,15/27) (x2=7.311,P=0.007).Conclusion In clinical practice,high-dose 131I on residual thyroid tissues should be considered for patients after non-high-risk DTC resection to improve the efficacy of 131I ablation at first dose when the volume of thyroid remnant tissues is low.