Analysis Of The Efficacy And Influencing Factors Of The First Radioactivity Iodine Remnant Ablation For The Patients With Differentiated Thyroid Cancer

Objective:To investigate the efficacy and influencing factors of radioiodine remnant ablation?RIA?for the first time after differentiated thyroid cancer?DTC?.Methods:106 cases of DTC with a complete record of clinical were collected from August 2015 to December 2017 in the Department of nuclear medicine of our hospital.Record the sex and age,surgical method,tumor location,invasion,lymph node metastasis,organ metastasis and thyroid static imaging before treatment,the residual thyroid weight,serum thyroglobulin?Tg?,thyroglobulin antibody?TgAb?,thyroid stimulating hormone?TSH?level,dose of radioiodine,¹³¹I whole body scintigraphy and neckultrasonography,CTresults.AccordingtotheAmericanThyroid Association?ATA?treatment guidelines,DTC patients were grouped according to the risk of relapse,patients'staging according to the eighth version of the American Joint Committee on Cancer?AJCC?.According to the success criteria recommended by the2014 edition of our country and the complete complete remission criteria after the clearance of nail clearance,then,?1?calculate the radioiodine treatment success rate and complete remission rate,?2?by single factor analysis of the index of the initial ablation success rate and complete remission rate would affect,?3?using Logistic regression analysis to find a clear effect of the success rate and complete remission rate of main factor,?4?to find the best predictors of radioiodine remnant ablation complete remission.Results:A total of 106 DTC patients were treated with radioiodine remnant ablation.1,The success rate of radioiodine remnant ablation was 66.9%,and the complete remission rate was 36.4%.2,Single factor analysis found a clear success before treatment,serum Tg,TgAb levels were significantly lower than those without success group?Z=-2.016,Z=-2.443,both P<0.05?,surgery for total resection of a clear success rate is higher than the near total resection??²=5.751,P=0.016<0.05?,patients without distant metastasis group for the first time.A significantly higher success rate and distant metastasis group??²=5.000,P=0.025<0.05?,the recurrence risk stratification for low risk group ablation success rate was significantly higher than that in high risk group??²=4.034,P=0.045<0.05?.And the patient's sex,age,lymph node metastasis,with no gross violations,the initial ablation dose,lesions in unilateral or bilateral and residual weight,a clear serum TSH level before treatment,AJCC staging and postoperative radioiodine from the first time,with Hashimoto's thyroiditis with nodules thyroid surgery,at times on the first postoperative radioiodine and the success of the impact is not significant.Single factor analysis showed that the radioiodine remnant ablation complete remission after treatment the serum Tg and TSH levels were significantly lower than that of non remission group?Z=-4.880,Z=-2.530,P<0.05?,clear a distance shorter operation time group complete remission rate is higher than the thyroidectomy from long time operation group(Z=9.501,P=0.002<0.05,not with lymph a clear node metastasis after complete remission rate was significantly higher than that of patients with lymph node metastasis group?Z=7.955,P=0.005<0.05?.The sex and age of the patients with distant metastasis,no gross invasion,the initial ablation dose,lesions in unilateral or bilateral and residual weight,AJCC stage,recurrence risk stratification,with Hashimoto's thyroiditis,and thyroid nodules,in operative times on the first postoperative radioiodine and the remission of the impact is not significant.3,Logistic regression analysis showed that serum Tg before radioiodine therapy,the level of TgAb and metastasis is a key factor affecting the success rate of a clear,clear effect for the first time Logistic a success rate of the regression equation is:11.798-0.014*serumTg-0.003*TgAbbeforeradioiodinetherapy-3.575*distant metastasis;serum before radioiodine therapy Tg,the TSH level is a clear effect of complete remission after the key factors influence the rate of complete remission rate for the first time a clear Logistic regression equation is:10.830-0.103*serum Tg-0.584*TSH before radioiodine remnant ablation.4,Serum Tg level is the best index to predict the complete remission of clear nail before the treatment.The cut-off value is 9.190ng/mL,the area under the corresponding ROC curve is 0.819,the sensitivity is 70.4%,and the specificity is80.6%.Conclusion:?1?radioiodine remnant ablation is an effective treatment for DTC.The success rate of the first time is 66.9%,and the complete remission rate is 36.4%after the first time.?2?the level of serum Tg and TgAb before treatment and the existence of distant metastasis are the key factors affecting the success rate of the first nail clearance.?3?the level of serum Tg and TSH before the treatment of nail clearance is the key factor affecting the complete remission rate of the first nail clearance.?4?the level of serum Tg before the first treatment of nail clearance is a good index to predict complete remission of nail clearance.