The Outcome Of Early Hypothyroidism After131I Therapy On Hashitoxicosis Patients And The Anlysis Of Thyroid Cytomorphologic Examination

Objective: In this study, to evaluate the vary circumstance ofanti-thyroperoxidase antibody(anti-TPOAb), anti-thyroglobulin anti-body(anti-TgAb) and thyroid stimulating hormone receptor antibody(TRAb) after¹³¹I therapy on hashitoxicosis patients. And observing the correlation ofthyroid cytomorphologic examination by fine-needle aspiration cytology(FNAC) with anti-TPOAb. Tried to find out the rules of early hypothyroidism,after¹³¹I therapy on hashitoxicosis patients. Hope can reduce the happening ofthe hypothyroidism.Methods:1Cytomorphologic ExaminationFNAC on each patient was performed in the supine position with theneck extended, using a21-gauge needle and a10-ml disposable syringe.Evenly spread smears were prepared and air dried as well as95%ethanolfixed for staining with the hematoxylin and eosin(HE).A detailed examination was done on the cytologic smear, randomlyselected10high-power field(HPF) in each stained smear. The number oflymphocytes in each smear was counted. Calculated the average number oflymphocytes/HPF. The grade was given as follow: mild:≤10lymphocytes/HPF; moderate:11²0lymphocytes/HPF; Serious:21³0lymphocytes/HPF; Very serious:≥31lymphocytes/HPF.2Laboratory ExaminationWithdraw the vein blood from the patients in empty stomach. Serumlevels of FT₃,FT₄,TSH and anti-TPOAb were assayed usingchemiluminscence immunoassay. The patients were divided into3groups,according to the level of anti-TPOAb. High titre anti-TPOAb: anti-TPOAb >3000U/mL; Moderate titre anti-TPOAb:1300U/mL <anti-TPOAb≤3000U/mL; Low titre anti-TPOAb: anti-TPOAb≤1300U/mL. The moderate andlow titer antibody groups were used as the control group.Serum levels of anti-TgAb and TRAb were assayed usingchemiluminscence immunoassay. Serum level of TRAb was divided into4levels:0¹.75UI/L is negative;1.76⁴.75IU/L is weak positive;4.76¹0.75IU/L is positive;≥10.76IU/L is strong positive.3Treatment and Follow-upTo evaluate the wight of thyroid by technetium scan and palpation.According the formula to calculate the dose of¹³¹I. The dose(MBq)=thyroid'swight(g)*the dose of per gram/the highest radiactive iodine uptake(%).Adjusting the dosage according to each patient's individual situation. Forexample age, the size of the thyroid gland, resilience and the severity ofdisease. And then the patient will be retested in two months, four months andsix months. Observing the vary circumstance of FT₃, FT₄, TSH andanti-TPOAb.Result:1The outcome of hypothyroidism after¹³¹I therapy on the patient in sixmonths: The rate of hypothyroidism is45.45%in the group of highanti-TPOAb titre; The rate of hypothyroidism is50%in the group of moderateanti-TPOAb titre; The rate of hypothyroidism is31.58%in the group of lowanti-TPOAb titre. The rate of hypothyroidism had no signficant difference inthe3groups.2FNAC examination shows: The results shows no signficant correlationbetween lymphocyte number and anti-TPOAb titre.3The change of the antibody3.1The anti-TPOAb level: a. The serum level of anti-TPOAb have beentreated two months rised compared with that before the treatment withstatistical signficant.(P=0.034<0.05) b. The serum anti-TPOAb level havebeen treated two months is similar to that have been treated four months,without statistical signficant.(P=0.806>0.05) And there are the similar station when comparing the serum anti-TPOAb level have been treated four monthsand six months.(P=0.394>0.05)The serum anti-TPOAb level have been treated six months obviouslyincreased compared with that before the treatment with statistical signficant.(Mean and Standard:3871.75±2790.20U/mL,5480.06±3950.20U/mL)3.2The anti-TgAb level: There are no signficant differences in eachcomparison.3.3The TRAb level: The strong positive rate of the serum TRAb levelare62.5%and89.6%. It is statistical signficant that compared the serum levelof TRAb have been treated two months with before.(P=0.002<0.05)Cnoclusion:1There are no signficant differences between the serum anti-TPOAblevel of hashitoxicosis patients and the rate of early hypothyroidism.2The FNAC examination shows no correlation between lymphocytenumber and the serum anti-TPOAb level.3The change of the antibody3.1The anti-TPOAb: The serum anti-TPOAb level rised when the patienttreated with¹³¹I.3.2The anti-TgAb: There are no signficant difference in before and aftertreatment.3.3The TRAb: The serum TRAb level rised when the patient have beentreated two months. It is not observably different in four months and sixmonths follow-ups compared with the serum TRAb level have been treatedtwo months.