中国癌症杂志 ›› 2018, Vol. 28 ›› Issue (6): 419-423.doi: 10.19401/j.cnki.1007-3639.2018.06.004

• 论著 • 上一篇    下一篇

慢性淋巴细胞性甲状腺炎对分化型甲状腺癌放射性碘清甲治疗效果的影响

张 腾1,2,胡厚洋2,柏庆花2,宋丽萍1,林岩松2   

  1. 1. 锦州医科大学附属第一医院核医学科,辽宁 锦州121001;
    2. 中国医科院学院北京协和医学院核医学科,北京100730
  • 出版日期:2018-06-30 发布日期:2018-07-20
  • 通信作者: 宋丽萍 E-mail:songliping0416@163.com
  • 基金资助:
    国家自然科学基金(81571714);亚州太平洋地区甲状腺研究组(81571714,81771875)。

Effect of lymphocytic thyroiditis on response of differentiated thyroid cancer patients after 131I therapy

ZHANG Teng1,2, HU Houyang2, BAI Qinghua2, SONG Liping1, LIN Yansong2   

  1. 1. Department of Imaging and Nuclear Medicine, the First Affiliated Hospital of Jinzhou Medical University, Jinzhou 121001, Liaoning Province, China; 2. Department of Nuclear Medicine, PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Published:2018-06-30 Online:2018-07-20
  • Contact: SONG Liping E-mail:songliping0416@163.com

摘要: 背景与目的:慢性淋巴细胞性甲状腺炎(chronic lymphocytic thyroiditis,CLT)是常见的甲状腺自身免疫炎性反应,本研究探讨其对分化型甲状腺癌(differentiated thyroid cancer,DTC)放射性碘-131131I)治疗效果的影响。方法:回顾性分析了2014—2016年就诊于北京协和医院的中低危DTC患者128例,根据术后病理学检查是否伴CLT分为CLT1组与CLT0组。采用卡方检验、秩和检验等对比两组患者一般临床病理特征,依据2015版美国甲状腺协会(American Thyroid Association)效果反应体系对两组患者131I治疗的治疗反应进行评价,并对CLT与131I治疗效果进行相关性分析,探讨CLT对131I治疗效果及预后的影响。结果:CLT1组原发灶较小(P=0.028)且女性多见(P=0.011),而在年龄、多灶性、淋巴结分期、被膜外侵犯及TNM分期方面,差异无统计学意义(P>0.05)。CLT1组与CLT0组患者131I治疗后疗效满意、疗效不确定、血清学疗效不满意、结构性疗效不满意率分别为72.7%(40/55) vs 68.5%(50/73)、14.5%(8/55) vs 13.7%(10/73)、3.6%(2/55) vs 6.8%(5/73)和9.1%(5/55)vs 10.9%(8/73),对比分析提示两组间治疗效果与短期预后未见明显差异。相关性分析显示CLT与治疗效果不相关(P=0.519)。结论:CLT不是影响DTC患者131I治疗效果及预后的因素。

关键词: 分化型状甲状腺癌, 淋巴细胞性甲状腺炎, 疗效反应, 131I治疗

Abstract: Background and purpose: Chronic lymphocytic thyroiditis (CLT) is a common autoimmune inflammation. The aim of this present study was to determine the relationship between CLT and the response of patients with differentiated thyroid carcinoma (DTC) who received surgery and radioactive iodine (131I) treatment for thyroid carcinoma. Methods: We retrospectively analyzed 128 patients who received initial treatment for thyroid disease at Peking Union Medical College Hospital from 2014 to 2016. Data of the participants with histologically confirmed DTC were analysed according to the presence (CLT1) or absence (CLT0) of concurrent CLT. One-way analysis, chi-square test and rank-sum test, Mann-Whitney test and multivariate analyses were used to evaluate the clinicopathological features. Correlation analysis was conducted between response to 131I and the presence or absence of concurrent CLT. The response was evaluated between two groups according to 2015 American Thyroid Association (ATA) response system. Results: Of the 128 patients, smaller tumor size and a greater female preponderance were noted in the patients with CLT compared with those without CLT (P=0.028, P=0.011, respectively). There was no significant difference in age, multifocality, stages of lymph nodes, capsular invasion and TNM classification system between the groups for DTC during 24-month mean follow-up period. There was no significant difference in response between two groups. The excellent response (ER) was 72.7%(40/55) and 68.5%(50/73), respectively. Indeterminate response (IR) was 14.5%(8/55) and 13.7%(10/73), respectively. Biochemical incomplete response (BIR) was 3.6%(2/55) and 6.8%(5/73), respectively. Structural incomplete response (SIR) was 9.1%(5/55) and 10.9%(8/73), respectively. Meanwhile, there was no correlation between response and the presence or absence of CTL (P=0.519). Conclusion: Our results do not support the hypothesis that CLT is associated with the response to 131I treatment for DTC patients.

Key words: Differentiated thyroid carcinoma, Lymphocytic thyroiditis, Response, 131I therapy