| Objective: Thyroid cancer(TC) is the more common malignancy of the endocrine system.In recent years, the incidence of thyroid cancer tended to increase.In the clinical differentiated thyroid carcinoma(DTC) is more common,accounting for ninety percent of TC.Currently, the most effective method of treatment for DTC recognized at home and abroad is surgery plus postoperative 131 I plus thyroid hormone suppression therapy program.Use of radioactive iodine 131 emitted energy β-ray clear DTC postoperative residual thyroid tissue or occult metastases,which can effectively prevent disease recurrence and metastasis,also can significantly improve the survival rate of patients with DTC.Clinical effect is remarkable.Due to salivary gland like thyoid presence Sodium Iodide Symporter(NIS),so the 131 I in the treatment of patients with differentiated thyroid carcinoma also have some impact on salivary gland.In recent years,scholars get more and more attention on chronic sialadenitis caused by 131I treatment of TC, however, salivary gland dysfunction one year after 131 I treatment of TC has not been reported in the literature. This paper discusses:(1) Investigate changes in salivary glands by direct comparison of two salivary gland scintigraphies(SGSs) taken before and at one years after an radioactive iodine ablation combined function classification method.(2) Investigate the impact on salivary gland function caused by different doses of 131 I treatment of patients with DTC one year later.(3) After one year treatment of radioactive iodine in patients with DTC, the occurrence of chronic radiation sialadenitis(4) If there is some correlation on chronic radiation sialadenitis secondary symptoms of dry mouth and the number of salivary gland dysfunction.Methods: Choose 71 patients underwent surgery due to differentiated thyroid cancer from September 2013 to March 2014 at 210 Hospital of Dalian where they undewwent131 I treatment. They take scintigraphy in Department of Nuclear Medicine lines in the Second Affiliated Hospital of Dalian Medical University. The range of 131 I application dose is 3.7 GBq-5.55 GBq. scintigraphic taken before and at one year after an RAI ablation.Outline bilateral parotid and submandibular glands and corresponding background area by the technology of ROIs, and calculate concentrate index of the bilateral parotid and submandibular glands as a parameter to assess the ability of the gland concentrate of radiopharmaceuticals.calculate secrete index after acid stimulation of salivary gland to assess The ability of the gland secrete radiopharmaceuticals.Changes in salivary gland function were graded as mild, moderate,or severe according to the differences in CI and SI between the two scintigraphic.investigate changes in salivary glands function by direct comparison of two salivary gland scintigraphies taken before and at one year after an radioactive iodine ablation.Results:(1) Worsening of the CI was observed in 64 of 284 salivary glands(total: 22.7%;mild: 4.8%, moderate: 7.9%, severe: 10%), and in 34 of 71 the patients(47%) had a worsening CI for at least one of four salivary glands(parotid,submandibular glands).A decrease in SI was observed in 58 of 284 salivary glands(total: 20.3%; mild: 5.4%, moderate: 6.8%, severe:8.1%), and 43.7% of the patients experienced a decrease in the SI of at least one of the four salivary glands.(2) Changes in salivary gland function were more common in patients receiving5.55 GBq, compared with 3.7 GBq, P=0.04.(3) 12 patients(16.9%) with chronic radiation sialadenitis at one year after RAI ablation.(4) The number of salivary glands with moderate or severe worsening of the CI was positively correlated with the development of dry mouth,P<0.01. The number of salivary glands with moderate or severe decreases in the SI was also correlated with the development of dry mouth,P<0.01.Conclusion:(1) About 20% of the salivary glands were dysfunctional on one year after a single radioactive iodine ablation.parotid injury caused by 131 I is more serious than the submandibular gland.(2) The damage of salivary gland function is positively correlated with the doses of131 I.(3) Patients with a history of acute radiation sialadenitis are more prone to chronic radiation sialadenitis.(4) Xerostomia was more associated with the prevalence of salivary glands with moderate or severe worsening of CI or SI. |
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