重组人促甲状腺激素辅助131I在儿童和青少年分化型甲状腺癌的临床研究

目的 评估重组人促甲状腺激素(rhTSH)辅助¹³¹I对治疗儿童和青少年分化型甲状腺癌的安全性和有效性。方法 本研究共纳入87例分化型甲状腺癌患者,¹³¹I疗前注射重组人促甲状腺激素的46例患者为实验组,¹³¹I疗前停用甲状腺素药物的41例患者为对照组,对其进行回顾性调查研究。结果 实验组患者在注射重组人促甲状腺激素后第1天、第3天和第6天血清中促甲状腺激素浓度间存在统计学差异,第三天的浓度最高。¹³¹I疗前两组患者的促甲状腺激素浓度存在统计学差异(t=2.362,P=0.023)。对于甲状腺球蛋白抗体阴性患者,对照组患者的血清甲状腺球蛋白浓度显著高于实验组rhTSH注射第3天浓度(1.5±1.2 vs. 0.7±1.4,P=0.034)。¹³¹I清甲3~8个月后全身显像结果显示,实验组34例(84%)患者无放射性物,对照组例40例(87%)患者无放射性物,实验组与对照组患者间不存在统计学差异(χ²=0.277,P=0.599)。实验组和对照组患者¹³¹I再次清甲的原因分析结果显示不存在统计学差异(P=0.875)。结论 在短期内重组人促甲状腺激素和停用促甲状腺激素对于¹³¹I清甲治疗在甲状腺清除、生化缓解、短期复发等结局不存在统计学差异。重组人促甲状腺激素介导¹³¹I清甲治疗对于儿童和青少年分化型甲状腺癌是一个更好的方法。

Study on rhTSH-aided radioiodine treatment with 131 I therapy in children and adolescents with differen-tiated thyroid cancer

Objective The study is mainly on the effect and outcome of 131 I treatment for children and adolescents with differentiated thyroid cancer .Methods We compared the difference between rhTSH -aided ra-dioiodine treatment and L -thyroxin withdrawal .Our study collected 87 patients in a retrospective study .In order to analysis the effect,we divided into two groups.The experimental group has 46 patients,and control check has 41 patients.We compared the basic characteristics and mortality in different groups by χ2 -test,t-test and F-test based on data type .Results The thyroid stimulating hormone concentrations of experimental group patients have significant differences in the first ,the third and the sixth day after the injected of rhTSH ,the third day is the highest.The TSH concentration has significant difference between the two groups before 131I treatment(t=2.362, P=0.023).For the Tg(thyrobolulin)negative patients,Tg concentration in control check is higher than the third day after injected of rhTSH in the experiment group (1.5 ±1.2 vs.0.7 ±1.4,P=0.034).Whole body image has been done by scintigraphic after 3~8 months of 131I treatment.Thirty four(84%)patients have no radioiodine up-take in experiment group,and 40(87%)patients have no radioiodine uptake in control check ,there is no differ-ence between the two groups (χ2 =0.277,P=0.599).There is no difference between the two groups on the rea-son for retreatment(P=0.875).Conclusion The outcome of rhTSH -aided radioiodine treatment is similar to L-thyroxin withdrawal in short -term recurrences ,and rhTSH-aided radioiodine treatment with 131 I therapy for children and adolescents with DTC is a better method .