Evaluation Of Efficacy Of ¹³¹I In Treating DTC With Pulmonary Metastasis And Its Influencing Factors

Objective:To investigate the efficacy and influencing factors of ¹³¹I in the treatment of patients with DTC with pulmonary metastasis.Methods:Retrospective analysis was performed on 120 patients with DTC pulmonary metastasis who received ¹³¹I treatment.Clinical history data of patients before and after each treatment and follow-up were collected.All patients received ¹³¹I treatment.Usingχ2test and chi-square test were employed to evaluate the date set.Logistic regression was used to analyze the factors affecting efficacy.The difference was statistically significant with P<0.05.Results:1.After ¹³¹I treatment,most of the patients with pulmonary metastasis from DTC could achieve partial or complete remission,among which 27 cases（22.5%,27/120）had satisfactory efficacy,14 cases（11.7%,14/120）had uncertain efficacy,53 cases（44.1%,53/120）had poor biochemical efficacy,and 26 cases（21.7%,26/120）had poor structural efficacy.2.Analysis showed that gender,age of first diagnosis DTC,with pulmonary metastasis age,primary tumor pathological type,primary tumor number,the biggest primary tumor diameter,whether the infringement of the capsule and the surrounding,the presence of vascular tumor emboli and presence of comorbid nodular goiter,lymph node metastasis or not,whether with other pulmonary metastasis before ¹³¹I therapy for the first time,TSH in there was no statistically significant difference between the groups（P>0.05）;There were statistically significant differences in s-Tg before the first and last ¹³¹I treatment,TSH before the last ¹³¹I treatment,maximum pulmonary metastatic lesion diameter,whether pulmonary metastatic lesion was sensitive to iodine,number of ¹³¹I treatment,and cumulative total dose of ¹³¹I treatment among all groups（P<0.05）.3.Logistic regression analysis showed that whether the lung metastatic lesion was sensitive to iodine（P=0.000）,the level of s-Tg before the last ¹³¹I treatment（P=0.003）,and the maximum pulmonary metastatic lesion diameter（P=0.009）were significant,which were independent factors affecting the treatment efficacy of ¹³¹I.4.The ROC curve AUC of s-Tg level before the last ¹³¹I treatment to predict the efficacy of ¹³¹I treatment was 0.994,P<0.05（sensitivity 98.9%,specificity 96.3%）;The ROC curve（AUC）of the maximum lung lesion diameter predicting the therapeutic effect of ¹³¹I was0.655（P<0.05）（sensitivity 49.5%,specificity 81.5%）.Conclusion:1.Radioactivity ¹³¹I treatment has a definite effect on patients with DTC pulmonary metastasis2.Whether pulmonary metastasis are sensitive to iodine,s-Tg level before the last ¹³¹I treatment and the maximum diameter of lung lesions are independent factors affecting the curative effect of ¹³¹I treatment in patients with pulmonary metastasis of DTC,and the lung metastasis are sensitive to iodine,the smaller the maximum diameter of lung metastases,the lower the level of s-Tg,the higher the cure rate of ¹³¹I treatment in patients.3.S-Tg level before the last ¹³¹I treatment has a high predictive value for the therapeutic effect of ¹³¹I,and the maximum lung metastatic lesion diameter has a low predictive value for the therapeutic effect of ¹³¹I.