Multiple-factor analysis of the first radioactive iodine therapy in post-operative patients with differentiated thyroid cancer for achieving a disease-free status.
Multiple-factor analysis of the first radioactive iodine therapy in post-operative patients with differentiated thyroid cancer for achieving a disease-free status.
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分化型甲状腺癌术后首次放射性碘治疗达到无病状态的多因素分析
DOI：
10.1038/srep34915
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发表时间：
2016-10-10
影响因子：
4.6
通讯作者：
Wang S
中科院分区：
文献类型：
--
作者：
Liu N;Meng Z;Jia Q;Tan J;Zhang G;Zheng W;Wang R;Li X;Hu T;Upadhyaya A;Zhou P;Wang S
131 I治疗是分化型甲状腺癌（DTC）的重要治疗手段。131 I消融失败严重影响患者的预后。本研究旨在分析影响首次131 I治疗后无病状态实现的潜在预测因素。本文回顾性分析了315例DTC患者的临床资料，并对其多因素进行了分析。肿瘤大小、病理分期、淋巴结（LN）转移、远处转移、美国甲状腺协会推荐的风险、消融前甲状腺球蛋白（Tg）和促甲状腺激素（TSH）在成功组和失败组之间显示出显著差异。通过受试者工作特征曲线分析，Tg和TSH预测成功结局的临界值分别为3.525 ng/mL和99.700 uIU/ml。二元Logistic回归分析显示肿瘤分期T3或T4、LN转移至N1 b站、中高危、消融前Tg ≥ 3.525 ng/ml和TSH <99.700 μIU/mL与治疗失败显著相关。达到无病状态的Logistic回归方程可以表示为：y（治疗成功）= −0.270-0.503 X1（LN转移）−0.236 X2（Tg）+ 0.015 X3（TSH）。本研究表明LN转移、消融前Tg和TSH是首次131 I治疗达到无病状态的最有力预测因素。
131I treatment is an important management method for patients with differentiated thyroid cancer (DTC). Unsuccessful 131I ablation drastically affects the prognosis of the patients. This study aimed to analyze potential predictive factors influencing the achievement of a disease-free status following the first 131I therapy. This retrospective review included 315 DTC patients, and multiple factors were analyzed. Tumor size, pathological tumor stage, lymph node (LN) metastasis, distant metastasis, American Thyroid Association recommended risks, pre-ablation thyroglobulin (Tg), and thyroid stimulating hormone (TSH) displayed significant differences between unsuccessful and successful group. Cutoff values of Tg and TSH to predict a successful outcome were 3.525 ng/mL and 99.700 uIU/ml by receiver operating characteristic curves analysis. Binary logistic regression analysis showed that tumor stage T3 or T4, LN metastasis to N1b station, intermediate and high risks, pre-ablation Tg ≥ 3.525 ng/ml and TSH <99.700 μIU/mL were significantly associated with unsuccessful outcomes. Logistic regression equation for achieving a disease-free status could be rendered as: y (successful treatment) = −0.270–0.503 X1 (LN metastasis) −0.236 X2 (Tg) + 0.015 X3 (TSH). This study demonstrated LN metastasis, pre-ablation Tg and TSH were the most powerful predictors for achieving a disease-free status by the first 131I therapy.
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