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目的研究腺叶切除不完全的分化型甲状腺癌(DTC)患者实施放射性碘(~(131)I)清除甲状腺组织(清甲)治疗的效果。方法回顾性分析DTC术后接受~(131)I清甲治疗的103例患者的临床资料。根据甲状腺平面显像结果分为腺叶切除不完全组(n=33)和腺叶切除完全组(n=70)。首次~(131)I清甲剂量为1.11～3.7 GBq(30～100 mCi)。3～6个月后复查并评估清甲效果:若诊断剂量~(131)I全身显像显示颈部无放射性摄取即认为清甲完全;若有放射性摄取,即认为清甲不完全,需再次行~(131)I清甲治疗,定期随访复查清甲效果。结果实施3次清甲治疗的成功率,腺叶切除完全组分别为61.43%、88.89%和100%,腺叶切除不完全组分别为21.21%、46.15%和78.57%。统计学分析表明,腺叶切除完全组的第1、2次清甲疗效与腺叶切除不完全组的第2、3次清甲疗效比较,差异均无统计学意义(P>0.05)。结论对于甲状腺腺叶切除不完全的DTC患者,实施~(131)I治疗的一次清甲成功率较低,但经2～3次治疗后同样可达到较高的清甲疗效。尤其适用于再次手术可能会导致严重的手术并发症或拒绝再次手术的患者。
Objective To investigate the effect of radioactive iodine (131I) on the removal of thyroid tissue from patients with differentiated thyroid cancer (DTC) with incomplete lobectomy. Methods The clinical data of 103 patients treated with ~(131) I-recovery after DTC were retrospectively analyzed. According to the results of thyroid planar imaging, the incomplete lobectomy group (n=33) and the complete lobectomy group (n=70) were included. The first (131) I dose was 1.11-3.7 GBq (30-100 mCi). 3 to 6 months later review and evaluate the effect of clear armor: If the diagnostic dose of ~ (131) I whole body imaging shows that there is no radioactive uptake of the neck that is completely clear; if there is radioactive uptake, that is, incomplete armor, need to be again Line ~ (131) I Qingjiao treatment, regular follow-up review Qingjia effect. Results The success rate of three times of clearing treatment was 61.43%, 88.89% and 100% in the complete lobectomy group, and 21.21%, 46.15% and 78.57% in the incomplete lobectomy group, respectively. Statistical analysis showed that there was no significant difference in the efficacy of the first and second clearance armor in the complete lobectomy group compared with the second and third armorectomy in the incomplete lobectomy group (P>0.05). Conclusions For patients with DTC with incomplete thyroidectomy, the success rate of first armoring with 131I treatment is lower, but after 2 or 3 treatments, the higher armor treatment is also achieved. It is especially suitable for patients who may have reoperations that may cause serious surgical complications or who refuse to undergo reoperation.