检验医学与临床2024，Vol.21Issue(1)：70-74,5.DOI:10.3969/j.issn.1672-9455.2024.01.016
131I+TSH抑制治疗对分化型甲状腺癌术后患者甲状腺功能、免疫功能及复发转移的影响
Effects of 131I+TSH inhibition therapy on postoperative thyroid function,immune function,recurrence and metastasis in patients with differentiated thyroid cancer
摘要
Abstract
Objective To investigate the clinical efficacy of 131I+TSH inhibition therapy after surgery in the patients with differentiated thyroid cancer(DTC)and its effects on the thyroid function,immune func-tion,recurrence and metastasis.Methods A total of 97 patients with DTC receiving the treatment in this hos-pital from January 2018 to December 2019 were retrospectively selected and divided into the control group(57 cases,adopting the TSH inhibition therapy)and observation group(40 cases,combining 131I treatment on the basis of control group)according to different postoperative treatment plans.The clinical effect of residual thy-roid clearance,levels of thyroid function indexes[free triiodothyronine(FT3),free thyroxine(FT4),thyroid stimulating hormone(TSH)and thyroglobulin(Tg)],thyroid antibody indexes[thyrotropin receptor anti-body(TRAb),anti-thyroglobulin antibodies(TgAb),thyroid peroxidase antibody(TPOAb)]and immune function indexes[CD3+,CD4+,CD8+T lymphocyte subsets ratio]were observed in the two groups.The re-currence and metastasis in postoperative 1,3 years in the two groups were followed up and statistically ana-lyzed.Results The complete clearance rate in the observation group was 72.5％,which was significantly higher than 52.6％in the control group,the difference was statistically significant(P＜0.05).After treat-ment,the FT3 and FT4 levels in the two groups increased significantly,while the TSH and Tg levels de-creased significantly;There was no statistical significance in FT3,FT4 and TSH levels between the observa-tion group and the control group(P＞0.05),but the Tg level in the observation group was significantly lower than that in the control group with statistical difference(P＜0.05).After treatment,the levels of TRAb,TgAb,TPOAb and the proportion of CD8+in the two groups decreased significantly,while the proportions of CD3+and CD4 increased significantly compared with before treatment,moreover the levels in the observation group were better than those in the control group,the differences were statistically significant(P＜0.05).The recurrence rates in postoperative 1 and 3 years in the observation group were 0 and 7.5％respectively,and the metastasis rates were 2.5％and 10.0％respectively.The recurrence rates in the control group were 14.4％and 22.8％,and the metastasis rates were 15.8％and 28.1％respectively,and the differences between the two groups were statistically significant(P＜0.05).Conclusion The 131I+TSH inhibition therapy could improve the efficacy of clearing nail,reduce TSH and Tg levels,maintain the thyroid function and improve the immune function of the patients,inhibit the tumor recurrence and metastasis,and increase the prognosis and survival of the patients.关键词
131I/促甲状腺激素/抑制治疗/分化型甲状腺癌/甲状腺功能/免疫功能/复发/转移Key words
131I/thyroid stimulating hormone/inhibition therapy/differentiated thyroid carcinoma/thyroid function/immune function/relapse/metastasis分类
医药卫生引用本文复制引用
薛媛,石昊,张杰,李二乐,拓明祥..131I+TSH抑制治疗对分化型甲状腺癌术后患者甲状腺功能、免疫功能及复发转移的影响[J].检验医学与临床,2024,21(1):70-74,5.基金项目
陕西省重点研发计划项目(2021SF-264). （2021SF-264）
