Clinical outcome after<sup>131</sup>I treatment in differentiated thyroid cancer with negative stimulated thyroglobulin and lymph node metastasis

卢承慧; 刘新峰; 王国强; 王增华; 王叙馥

doi:10.19401/j.cnki.1007-3639.2019.06.005

您当前的位置：

首页 >

文章列表页 >

Clinical outcome after¹³¹I treatment in differentiated thyroid cancer with negative stimulated thyroglobulin and lymph node metastasis

更新时间：2026-01-27

- Clinical outcome after¹³¹I treatment in differentiated thyroid cancer with negative stimulated thyroglobulin and lymph node metastasis
- China Oncology Vol. 29, Issue 6, Pages: 429-433(2019)
- 作者机构：
  
  青岛大学附属医院核医学科,山东,青岛,266003
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2019.06.005
  CLC： R736.1
- Published Online：12 July 2019，
  
  Published：12 July 2019
- 稿件说明：
移动端阅览
卢承慧，李娇，刘新峰，王国强，王增华，王叙馥. 治疗前刺激性甲状腺球蛋白阴性合并淋巴结转移的分化型甲状腺癌

卢承慧, 刘新峰, 王国强, et al. Clinical outcome after¹³¹I treatment in differentiated thyroid cancer with negative stimulated thyroglobulin and lymph node metastasis[J]. China Oncology, 2019, 29(6): 429-433.
卢承慧，李娇，刘新峰，王国强，王增华，王叙馥. 治疗前刺激性甲状腺球蛋白阴性合并淋巴结转移的分化型甲状腺癌 DOI： 10.19401/j.cnki.1007-3639.2019.06.005.

卢承慧, 刘新峰, 王国强, et al. Clinical outcome after¹³¹I treatment in differentiated thyroid cancer with negative stimulated thyroglobulin and lymph node metastasis[J]. China Oncology, 2019, 29(6): 429-433. DOI： 10.19401/j.cnki.1007-3639.2019.06.005.

摘要

背景与目的：治疗前刺激性甲状腺球蛋白（preablative stimulated thyroglobulin，ps-Tg）阴性和

131

I显像阴性往往提示分化型甲状腺癌（differentiated thyroid cancer，DTC）患者无病生存状态，然而临床上常遇到ps-Tg阴性伴

131

I显像示淋巴结转移的情况。探讨甲状腺全切术后ps-Tg阴性伴

131

I显像示淋巴结转移患者的临床转归及其影响因素。方法：2015年5月—2018年1月在青岛大学附属医院首次行

131

I治疗的ps-Tg2 ng/mL伴淋巴结转移的DTC患者130例，随访6~36个月，根据临床转归情况分为满意（excellent response，ER）、不确切（indeterminate response，IDR）、影像学反应欠佳（structural incomplete response，SIR）3组，比较3组患者的性别、年龄、原发肿瘤大小、腺外浸润、T分期、术后N分期、淋巴结转移率、复发风险分层、

131

I治疗剂量、ps-Tg及甲状腺球蛋白抗体（thyroglobulin antibody，TgAb）等特征的差异，对有意义的因素进一步行亚组分析。结果：3组患者在N分期（χ

=11.274，P=0.024）、ps-Tg（H=9.579，P=0.008）和TgAb（H=11.632，P=0.003）方面差异有统计学意义，在性别（χ

=0.559，P=0.756）、年龄（F=0.408，P=0.666）、原发肿瘤大小（H=1.834，P=0.400）、腺外浸润（χ

=1.345，P=0.510）、T分期（χ

=4.494，P=0.610）、淋巴结转移率（H=3.358，P=0.187）、复发风险分层（χ

=3.008，P=0.556）和首次131I治疗剂量（H=1.335，P=0.513）方面差异均无统计学意义。术后分期N

组14例，100.00%（14/14）达到ER，N

组18例，其中77.78%（14/18）达ER，

22.22%（4/18）达IDR，N

组98例，63.26%（62/98）达ER，18.37%（18/98）达IDR，18.37%（18/98）达SIR。IDR组的中位ps-Tg水平为1.85 ng/mL显著高于ER组的1.09 ng/mL（t=2.976，P=0.003）和SIR组的0.39 ng/mL（t=2.468，P=0.014），而SIR组的中位TgAb水平为713.10 U/mL，显著高于ER组的40.42 U/mL（t=3.409，P=0.001）和IDR组的39.02 U/mL（t=2.381，P=0.017）。结论：对于ps-Tg阴性、首次

131

I治疗后扫描发现淋巴结转移的患者，术后N分期、ps-Tg及TgAb水平可作为预测其临床转归的敏感指标。术后分期为N

、ps-Tg水平很低但TgAb水平明显升高者更易出现治疗反应欠佳。

Abstract

Background and purpose: Negative pre-ablative stimulated thyroglobulin (ps-Tg) with negative

131

I scan indicates disease-free survival of patients with differentiated thyroid cancer (DTC). However

negative ps-Tg with lymph node metastasis detected by

131

I scan often shows in clinic. The purpose of this study was to investigate the prognosis of postoperative DTC patients with lymph node metastasis and negative ps-Tg and its influencing factors. Methods: From May 2015 to Jan. 2018

130 DTC patients with lymph node metastasis who underwent

131

I treatment for the first time in the Affiliated Hospital of Qingdao University were followed up for 6-36 months. According to the clinical outcome

they were divided into 3 groups: excellent response (ER)

indeterminate response (IDR) and structural incomplete response (SIR). The gender

age

size of primary tumor

extraglandular infiltration

T stage

N stage

lymph node metastasis rate

recurrence risk stratification

ps-Tg and thyroglobulin antibody (TgAb) were compared among the three groups. Subgroup analysis of significant factors was further carried out. Results: There were significant differences in N stage (χ

=11.274

P=0.024)

ps-Tg (H=9.579

P=0.008) and TgAb (H=11.632

P=0.003) among groups. There was no significant difference in gender (χ

=0.559

P=0.756)

age (F=0.408

P=0.666)

primary tumor size (H=1.834

P=0.400)

extraglandular infiltration (χ

=1.345

P=0.510)

T stage (χ

=4.494

P=0.610)

lymph node

metastasis rate (H=3.358

P=0.187)

recurrence risk stratification (χ

=3.008

P=0.556) and dose of radioiodine (H=1.335

P=0.513). 100% (14/14) reached ER in N0 group. 77.78% (14/18) reached ER

and 22.22% (4/18) reached IDR in N

group. 63.26% (62/98) reached ER

18.37% (18/98) reached IDR

and 18.37% (18/98) reached SIR in N

group. The median ps-Tg level in IDR group was 1.85 ng/mL

significantly higher than that in ER group (t=2.976

P=0.003) and SIR group (t=2.468

P=0.014). The median TgAb level in SIR group was 713.1 U/mL

significantly higher than that in ER group (40.42 U/mL

t=3.409

P=0.001) and IDR group (39.02 U/mL

t=2.381

P=0.017). Conclusion: N stage

ps-Tg and TgAb levels can be used as sensitive indicators for predicting clinical outcomes in DTC patients with negative ps-Tg and lymph node metastasis after the first

131

I treatment. The prognosis of patients with N

stage is better

and those with N

low ps-Tg level but significantly elevated TgAb level are more likely to have poor treatment response.

关键词

Keywords

references

Views

2673

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

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

Clinical analysis of short-term outcome in low-to-intermediate-risk thyroid cancer after low-dose¹³¹I therapy

The significance of stimulated thyroglobulin in predicting neck and distant metastasis in postoperative patients with differentiated thyroid carcinoma before the first¹³¹I ablation therapy

Cervical ultrasound and thyroglobulin in diagnosis of recurrence of differentiated thyroid carcinoma

Advances in understanding the correlation between lymph node metastasis and immune regulation in breast cancer through spatiotemporal transcriptomic analysis

Related Author

Wenting GUO

Zhuanzhuan MU

Zheng LI

Yingqiang ZHANG

Xiaona JIN

Yansong LIN

宋娟娟

刘延晴

Related Institution

Department of Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

Department of Nuclear Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College

Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine

Department of Radionuclide Treatment Center, Beijing Nuclear Industry Hospital

中国医学科学院北京协和医学院北京协和医院核医学科

AI问答

⁰

Clinical outcome after131I treatment in differentiated thyroid cancer with negative stimulated thyroglobulin and lymph node metastasis

DOI：10.19401/j.cnki.1007-3639.2019.06.005

摘要

Abstract

关键词

Keywords

references

Clinical outcome after¹³¹I treatment in differentiated thyroid cancer with negative stimulated thyroglobulin and lymph node metastasis