Effect Of Initial 131 Iodine Treatment On Salivary Gland Function In Postoperative Patients With Differentiated Thyroid Carcinoma

Objective:To evaluate the correlation between99mTc O4-imaging related functional indexes of bilateral parotid and submandibular glands and general clinical data changes before the first ¹³¹I treatment and 6 months after treatment,and to explore the correlation between functional indexes changes and dry mouth degree score.Methods:88 Patients with complete clinical data after DIC surgery admitted to the nuclear medicine department of Yijishan Hospital of Wannan Medical College from October 2019 to February 2021,Salivary gland function imaging was used to calculate the patient’s intake index（UI）and excretion fraction（SR）（%）before and 6 months after treatment.Collect the patient’s age,sex,treatment before and after 6 months of Tg Ab,Tg,TSH level and other clinical data.Finally,UI and SR（%）levels before and 6months after treatment were taken as independent variables,while age,gender,weight of the residual thyroid and treatment dose were taken as dependent variables.（1）Changes of UI and SR（%）levels before and after treatment;（2）The effect of clinical data on UI and SR（%）levels before and after treatment;（3）Independent influencing factors of UI and SR（%）levels before and after treatment.Results:（1）Before ¹³¹I treatment,the UI level of the right parotid gland was significantly different from that of the left parotid gland（Z=-2.763,P=0.015）.The UI level of left and right parotid glands 6 months after ¹³¹I treatment was significantly different from that before treatment（Z=-3.831,P=0.021;Z=-2.698,P=0.007）.The UI level of bilateral submandibular gland 6 months after treatment was statistically significant compared with the level before ¹³¹I treatment（Z=-0.281,P=0.03;Z=-2.944,P=0.005）.（2）Univariate analysis results showed that there were statistically significant differences in bilateral parotid UI levels between 150m Ci group and 100m Ci group 6 months after treatment（Z=-2.03,P=0.045）.（3）The results of multiple linear regression analysis showed that age,weight of the residual thyroid and treatment dose were independent influencing factors of UI changes of parotid gland 6 months after treatment.Age was an independent factor for the change of SR（%）level in parotid gland.Weight of the residual thyroid and treatment dose were independent influencing factors of UI changes of parotid gland.Age was an independent factor for the change of SR（%）level in parotid gland.（4）In the 76 cases followed up this time,46 cases（60.53%）had no dry mouth,23 cases（30.26%）had mild dry mouth,7 cases（9.21%）had moderate dry mouth,and 0 cases had severe dry mouth.In the 46 cases without xerstomia,19 cases（41.30%）showed no significant decrease in the uptake and excretion function of bilateral salivary glands,and 27 cases（58.7%）showed different degree of decrease in UI or SR（%）levels.Conclusion:1.There are differences in the uptake function of bilateral parotid glands in patients after DTC operation.2.¹³¹I treatment can cause impairment of salivary gland function,mainly the uptake function of parotid and submandibular glands;3.The higher dose of ¹³¹I will cause damage to the salivary glands,mainly to the secretion function of the parotid gland,but less to the function of the submandibular gland.4.Age,weight of the residual thyroid and treatment dose were independent influencing factors of parotid gland uptake function 6 months after treatment.and only age was the independent influencing factor for the change of parotid gland secretion function after treatment.