| Objectives:The levels of stimulated thyroglobulin(Tg) was influenced by tumor staging, Thyroid Stimulating Hormone(TSH) levels and other factors. Therefore, our study’s aim is to use TSH to adjusting the levels of Tg as a predictor of success for 131 iodine ablation remnant thyroid tissue, and to analysis whether Tg/TSH ratio can be used as a good predictor and to compare the values with Tg.Methods:A total of 190 patients with were differential thyroid carcinoma(DTC) retrospectively analyzed for the initial radioiodine ablation of residual thyroid tissue after total thyroidectomy, including 53 male,137 female patients, aged from 18 to 77 (average 38.98±0.88 years) from Jan 2014 to Nov 2015 in department of nuclear medicine, the First Affiliated Hospital of Guangxi Medical University. All of the patients were treated after total thyroidectomy for 3-4 weeks or stop taking euthyrox 3～4 weeks,and the serum TSH, Tg and TgAb were tested, and were performed 131-iodine whole body imaging after 5-7 days for treatment with radioiodine. Statistical analysis was performed using SPSS 20 software. The data of skewness distribution were showed with median(M) and interquartile range (IQR),and data of normal distribution with mean and standard deviation. Comparison of measurement data were tested T-test, count data using the wilcoxon rank sum test, compared with the rate of use of chi-square test. Using ROC curve analysis to obtain the optimal critical point of Tg and Tg/TSH value. Predictive factors influencing for efficacy of the treatment were analyzed by multivariate logistic regression analysis. For the analysis P value less than 0.05 was considered significant.Results:Ablation was successful in 67.37% of the 190 patients, but 32.63% did not succeed. Out of these 67.37% had successful ablation, while 32.63% had unsuccessful ablation. There was no significant difference in the pathological type, sex, age and lymph node metastasis between two groups. But, the unsuccessful group can see more distant metastasis than successful group (13.28% vs.25.81%). According to ROC curve, the area of under the cure of Tg and Tg/TSH ratio were 0.772 (95%CI:0.698-0.847) and 0.802 (95%CI:0.728-0.876),respectively.56.61% of unsuccessful group patients had Tg levels> 38.18 ng/ml, and the sensitivity and specificity is 87.50% and 58.06% for predicting unsuccessful ablation, respectively.58.06% of unsuccessful group patients had Tg/TSH ratio>0.969, and the sensitivity and specificity is 93.75% and 56.45% for predicting unsuccessful ablation, respectively. Multivariate logistic regression analysis shows that the higher the initial doses, the higher the successful rate. The successful ratio of serum Tg levels≤38.18 ng/ml is higher 3.14 times than Tg> 38.18 ng/ml. The successful ratio of serum Tg/STH ratio≤0.969 is higher 9.43 times than Tg/STH ratio> 0.969. Conclusions:Our study concluded that doses of ablation, serum Tg levels and Tg/TSH ratio is related factors for predicting the ablation outcome of radioactive for DTC. What’s more, the predictive value of Tg/TSH ratio was more stronger than serum Tg levels and this cancer provide an important reference value for clinical. |
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