甲状腺癌患者<sup>131</sup>I治疗前后CTC水平变化及临床意义

doi:10.3969/j.issn.1006-6233.2024.09.025

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摘要 目的: 探究甲状腺癌患者放射性碘同位素(¹³¹I)治疗前后外周血循环肿瘤细胞(CTC)水平变化,分析其临床意义。方法: 研究对象选取自本院2022年1月至2022年12月收治的108例行¹³¹I治疗的甲状腺癌患者,根据¹³¹I治疗12个月后预后情况将患者分为转移组(19例)和未转移组(89例),与¹³¹I治疗前后比较两组CTC水平,并对两组患者的一般资料进行比较,应用Logistic回归分析筛选影响患者¹³¹I治疗预后的因素。结果: ¹³¹I治疗前,CTC水平为15.51±1.67(FR/mL)显著高于治疗后CTC水平8.50±2.30(FR/mL)(P<0.05);未转移组治疗前后CTC水平差值显著高于转移组(P<0.05);两组患者的年龄、性别、住院天数、肿瘤类型、肿瘤位置、包膜侵犯情况、肿瘤T分期、残余甲状腺质量、手术时间至¹³¹I治疗时间、¹³¹I治疗的次数、颈部侧区淋巴结阳性数、是否合并桥本比较差异无统计学意义(P>0.05),颈部中央区淋巴结阳性数比较差异具有统计学意义(P<0.05);Logistic回归分析显示颈部中央区淋巴结阳性数是甲状腺癌患者甲状腺切除术后¹³¹I治疗后复发转移的独立影响因素。结论: 甲状腺切除术后进行¹³¹I治疗能有效改善患者CTC水平,出现复发转移患者的治疗前后CTC水平改善程度更低,CTC对预测甲状腺切除术联合¹³¹I治疗后复发转移具有较好的价值,颈部中央区淋巴结阳性数也是甲状腺癌患者¹³¹I治疗后复发转移的影响因素。

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	段俊
	徐海青
	鲁树华

关键词 ：甲状腺癌, 放射性碘同位素, 外周血循环肿瘤细胞

Abstract：Objective: To investigate the changes in peripheral blood circulating tumor cell (CTC) levels in patients with thyroid cancer before and after iodine radioisotope (¹³¹I) treatment and to analyze their clinical significance.Methods: A total of 108 patients with thyroid cancer who were treated with ¹³¹I in the hospital from January to December 2022 were selected as the study subjects. According to the prognosis after 12 months of treatment, the patients were divided into a metastasis group (19 cases) and a non-metastasis group (89 cases). CTC levels before and after treatment and general information of the two groups were comparatively analyzed. Logistic regression analysis was conducted to screen the prognostic factors.Results: CTC levels before and after treatment were (15.51±1.67) FR/mL and (8.50±2.30) FR/mL, with a statistically significant difference (P<0.05). The difference in CTC level in the non-metastasis group before and after treatment was significantly higher than in the metastasis group (P<0.05). There was no statistically significant difference between the two groups in terms of age, gender, length of hospital stay, tumor type, tumor location, capsule invasion, T stage, residual thyroid mass, time from surgery to ¹³¹I treatment, frequency of ¹³¹I treatment, positive lymph nodes in the lateral cervical region, and Hashimoto's thyroiditis (P>0.05). The difference in the number of positive lymph nodes in the central cervical region was statistically significant (P<0.05). Logistic regression analysis found that the number of positive lymph nodes in the central cervical region was an independent influencing factor for the recurrence and metastasis of thyroid cancer after ¹³¹I treatment.Conclusion: ¹³¹I treatment after thyroidectomy can effectively improve CTC levels in patients with thyroid cancer, and the improvement of CTC levels before and after treatment is lower in patients with recurrence and metastasis. CTC helps predict recurrence and metastasis after thyroidectomy combined with ¹³¹I treatment. The number of positive lymph nodes in the central cervical region is an independent influencing factor for the recurrence and metastasis of thyroid cancer after ¹³¹I treatment.

Key words： Thyroid cancer Iodine radioisotope Peripheral blood circulating tumor cell

基金资助:2022年安徽省重点研究与开发计划项目,(编号:2022e07020056)

引用本文:

段俊, 徐海青, 鲁树华. 甲状腺癌患者¹³¹I治疗前后CTC水平变化及临床意义[J]. 河北医学, 2024, 30(9): 1545-1549.
DUAN Jun, XU Haiqing, LU Shuhua. Changes and Clinical Significance of CTC Level in Patients with Thyroid Cancer before and after ¹³¹I Treatment. HeBei Med, 2024, 30(9): 1545-1549.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2024.09.025 或 http://www.hbyxzzs.cn/CN/Y2024/V30/I9/1545

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