^131I首次清除分化型甲状腺癌残留组织的影响因素探讨

目的观察^131I首次“清甲”的疗效及分析其影响因素。方法确诊分化型甲状腺癌（DTC）患者经手术治疗后行^131I治疗，然后按手术方式、术后治疗时间^131I的剂量进行分类，观察首次“清甲”的疗效。结果“清甲”成功率：甲状腺全切88．5％，次全切除44．4％；“清甲”时间术后1～2个月92．7％，1年以上50．0％；^131I剂量2．96GBq为47．6％，4．44GBq为82．8％。结论DTC治疗应以甲状腺全切及颈淋巴结清扫为首选治疗方式，术后1～2个月为^131I“清甲”最佳时机，首次“清甲”^131I剂量以4．44GBq（120mci）为宜。

The effect factors of first iodine-131 ablation of thyroid remnants in patients with differentiated thyroid cancer

Objective To observe the effect of the first iodine-131 ablation of thyroid remnants in pa-tients with differentiated thyroid cancer (DTC) and discuss factors that may be influential in the treatment. Meth-ods All DTC patients confirmed by pathology received iodine-131 therapy after necessary preparation. Accord-ing different operation procedures, time interval between operation and iodine-131 treatment and dose of iodine - 131, the patients were divided into different groups. Therapy effects were observed in different groups. Results Ablation successful rate was 88.5% in total thyroidectomy group, compared with 44.4% in subtotal thyroidecto-my group. 92.7% ablation rate was seen in the group of I-2 months time interval between operation and iodine - 131 treatment, while in the group of over 1 year time interval, only 50% ablationrate was achieved. Ablation successful rate was 47.6% in the group of low dose of iodine-131 (2.96GBq), compared with 82.8% in the high dose group (4.44GBq). Conclusions Total thyroidectomy and cervical lymph nodes dissection should be recommended for the patients with DTC. The better interval time between operation and iodine-131 ablation thy-roid remnants is 1～2 months. The high dose of iodine-131 shows better result than low dose of iodine-131 treatment.