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目的评估重组人促甲状腺激素(rhTSH)辅助~(131)I对治疗儿童和青少年分化型甲状腺癌的安全性和有效性。方法本研究共纳入87例分化型甲状腺癌患者,川I疗前注射重组人促甲状腺激素的46例患者为实验组,~(131)I疗前停用甲状腺素药物的41例患者为对照组,对其进行回顾性调查研究。结果实验组患者在注射重组人促甲状腺激素后第1天、第3天和第6天血清中促甲状腺激素浓度间存在统计学差异,第三天的浓度最高。~(131)I疗前两组患者的促甲状腺激素浓度存在统计学差异(t=2.362,P=0.023)。对于甲状腺球蛋白抗体阴性患者,对照组患者的血清甲状腺球蛋白浓度显著高于实验组rhTSH注射第3天浓度(1.5±1.2 vs.0.7±1.4,P=0.034)。~(131)I清甲3~8个月后全身显像结果显示,实验组34例(84%)患者无放射性物,对照组例40例(87%)患者无放射性物,实验组与对照组患者间不存在统计学差异(χ~2=0.277,P=0.599)。实验组和对照组患者~(131)I再次清甲的原因分析结果显示不存在统计学差异(P=0.875)。结论在短期内重组人促甲状腺激素和停用促甲状腺激素对于~(131)I清甲治疗在甲状腺清除、生化缓解、短期复发等结局不存在统计学差异。重组人促甲状腺激素介导~(131)I清甲治疗对于儿童和青少年分化型甲状腺癌是一个更好的方法。
Objective To evaluate the safety and efficacy of recombinant human thyrotropin (rhTSH) adjuvant ~ (131) I in the treatment of differentiated thyroid cancer in children and adolescents. Methods A total of 87 patients with differentiated thyroid cancer were enrolled in this study. Forty-six patients receiving thyroid stimulating hormone (HSTT) before treatment were selected as experimental group and 41 patients with thyroid hormone dosed before 131 I treatment as control group , Its retrospective study. Results There was a statistically significant difference in serum thyrotropin concentration between the first day, the third day and the sixth day after injection of recombinant human thyrotropin in the experimental group, with the highest concentration on the third day. There was a significant difference in thyrotropin concentrations between ~ (131) I and two groups before treatment (t = 2.362, P = 0.023). For thyroglobulin-negative patients, the serum thyroglobulin concentration of the control group was significantly higher than that of the rhTSH injection group on day 3 (1.5 ± 1.2 vs.0.7 ± 1.4, P = 0.034). The results of whole body imaging showed that there were no radioactive materials in 34 (84%) patients in the experimental group and 40 (87%) patients in the control group. There was no radioactive material in the experimental group and the control group There was no statistical difference between groups (χ ~ 2 = 0.277, P = 0.599). There was no significant difference (P = 0.875) in the analysis of the causes of 131I recirculation in the experimental group and the control group. Conclusion In the short term, there is no significant difference in the outcomes of thyroid clearance, biochemical remission and short-term recurrence of recombinant thyrotropin and thyroid-stimulating hormone in 131I treatment. Recombinant human thyrotropin-mediated 131I treatment of meningitis is a better approach for differentiated thyroid cancer in children and adolescents.