Clinical outcome of <sup>131</sup>I therapy in differentiated thyroid cancer patients with suspicious high thyroglobulin concentration

Wenting GUO; Zhuanzhuan MU; Zheng LI; Yingqiang ZHANG; Xiaona JIN; Yansong LIN

doi:10.19401/j.cnki.1007-3639.2022.05.006

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Clinical outcome of ¹³¹I therapy in differentiated thyroid cancer patients with suspicious high thyroglobulin concentration

Article | 更新时间：2025-12-31

- Clinical outcome of ¹³¹I therapy in differentiated thyroid cancer patients with suspicious high thyroglobulin concentration
- China Oncology Vol. 32, Issue 5, Pages: 410-416(2022)
- 作者机构：
  
  1. 中国医学科学院北京协和医学院北京协和医院医学科学研究中心,疑难重症及罕见病国家重点实验室,北京 100730
  2. 中国医学科学院北京协和医学院北京协和医院核医学科,疑难重症及罕见病国家重点实验室,北京 100730
  3. 核医学分子靶向诊疗北京市重点实验室,北京 100730
  4. 北京核工业医院核素诊疗中心,北京 102413
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2022.05.006
  CLC： R736.1
- Received：18 April 2022，
  
  Revised：2022-05-02，
  
  Published：30 May 2022
- 稿件说明：
移动端阅览
Wenting GUO, Zhuanzhuan MU, Zheng LI, et al. Clinical outcome of ¹³¹I therapy in differentiated thyroid cancer patients with suspicious high thyroglobulin concentration[J]. China Oncology, 2022, 32(5): 410-416.
DOI：

Wenting GUO, Zhuanzhuan MU, Zheng LI, et al. Clinical outcome of ¹³¹I therapy in differentiated thyroid cancer patients with suspicious high thyroglobulin concentration[J]. China Oncology, 2022, 32(5): 410-416. DOI： 10.19401/j.cnki.1007-3639.2022.05.006.

摘要

背景与目的：

分化型甲状腺癌（differentiated thyroid cancer

DTC）中可疑甲状腺球蛋白（thyroglobulin

Tg）水平增高但无明确结构性病灶者预后差异大

临床治疗决策存在较大争议

本研究拟探究

131

I治疗及不同治疗剂量对于这类患者临床转归的影响。

方法：

回顾并分析2007

#x02014;2021年就诊于北京协和医院核医学科的138例DTC全切术后可疑Tg水平增高的患者

依据首次

131

I治疗剂量分为低（剂量为1.11 GBq）、中（1.11 GBq

剂量

#x02264;3.70 GB

q）、高（3.70 GBq

剂量

#x02264;7.40 GBq）3组

观察不同剂量

131

I治疗后6个月的短期及后续未再行其他干预患者的长期疗效

并进一步观察经初始治疗评估为生化疗效不佳（biochemical incomplete response

BIR）患者的临床转归。采用受试者工作特征（receiver operating characteristic

ROC）曲线评估预测结构性疗效不佳（structural incomplete response

SIR）和远处转移的刺激性Tg（stimulated Tg

sTg）的最佳界值点。

结果：

低、中、高3个剂量组中分别有6.7%、13.5%、7.0%的患者短期疗效达到疗效满意（excellent response

ER）

3组间总体疗效差异无统计学意义（

=1.02

=0.60）。常规随访下3组患者的长期疗效同样差异无统计学意义（

=2.94

=0.23）。经初始治疗评估为BIR的患者经常规随访和再次

131

I治疗后的临床转归差异无统计学意义（

=324.5

=0.15）。预测SIR和远处转移的sTg最佳界值点分别为27.5和61.7 ng/mL。

结论：

可疑Tg水平增高的DTC患者复发率较高

以27.5 ng/mL为sTg界值点有助于尽早识别这部分患者。

131

I治疗有助于术后可疑Tg水平增高患者快速达到ER

但高剂量

131

I治疗未对患者的预后产生增益效应;再次

131

I治疗对于BIR患者未显示出进一步获益。

Abstract

Background and purpose:

The prognosis of differentiated thyroid cancer (DTC) patients with suspicious high thyroglobulin (Tg) concentration and without explicit structural lesions varies from each other

hence the clinical treatment decisions including

131

I therapy remain controversial. This study aimed to explore the effects of

131

I treatment and the therapeutic dose on the clinical outcome of these patients.

Methods:

The study included 138 DTC patients treated in Department of Nuclear Medicine

Peking Union Medical College Hospital from 2007 to 2021

who had undergone total thyroidectomy and subsequent

131

I therapy. All patients were divided into 3 groups as low dose (dose=1.11 GBq)

medium dose (1.11 GBq

dose

#x02264;3.70 GBq) and high dose (3.70 GBq

dose

#x02264;7.40 GBq) according to the dose of

131

I therapy. We compared the short-term and end-of period response to therapy among these three groups

and further observed the clinical outcome of patients with biochemical incomplete response (BIR) after initial treatment. The

receiver operating characteristic (ROC) curve was employed to evaluate the predictive value of stimulated Tg (sTg) levels in patients with structural incomplete response (SIR) and distant metastasis.

Results:

For the short-term response

the rate of excellent response (ER) was 6.7%

13.5% and 7.0% in low

medium and high dose group

respectively. The short-term response showed no statistically significant difference among three groups (

=1.02

=0.60). The end-of-period response among the three groups under routine follow-up also showed no significant difference (

=2.94

=0.23). No significant difference was observed in the clinical outcome of patients with BIR after routine follow-up and second

131

I treatment (

=324.5

=0.15). The diagnostic critical point (DCP) of sTg to predict SIR and distant metastasis was 27.5 and 61.7 ng/mL

respectively.

Conclusion:

DTC patients with suspicious high Tg concentration has high recurrence risk

taking 27.5 ng/mL as the cut-off of sTg is helpful to identify the patients with high recurrence risk early.

131

I treatment is helpful for these patients to achieve ER as soon as possible. However

high-dose

131

I did not have greater benefits on the prognosis of these patients. Second

131

I treatment showed no further benefit for BIR patients.

关键词

Keywords

references

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Department of Nuclear Medicine, Beijing Hope Medcare

Department of Nuclear Medicine, Chifeng Municipal Hospital, Chifeng 024000, Inner Mongolia Autonomous Region

Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, State Key Laboratory of Complex Severe and Rare Diseases, Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine

AI问答

⁰

Clinical outcome of 131I therapy in differentiated thyroid cancer patients with suspicious high thyroglobulin concentration

DOI：10.19401/j.cnki.1007-3639.2022.05.006

摘要

Abstract

关键词

Keywords

references

Clinical outcome of ¹³¹I therapy in differentiated thyroid cancer patients with suspicious high thyroglobulin concentration