Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2016, Vol. 38 ›› Issue (1): 83-87.doi: 10.3881/j.issn.1000-503X.2016.01.015

• Orginal Article • Previous Articles     Next Articles

Response to 131I Therapy in Non-metastatic Differentiated Thyroid Cancer Patients with Preablative Stimulated Thyroglobulin above 10 ng/ml

Min HOU1, Teng ZHAO2, Xue YANG2, Jiao LI2, Hui LI1, Yan-song LIN1()   

  1. 1Department of Nuclear Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
    2Department of Oncology,the Affiliated Hospital of Qingdao University,Qingdao,Shandong 266003,China
  • Received:2015-02-11 Online:2016-01-15 Published:2016-03-02
  • Supported by:
    Supported by the National Natural Sciences Foundation of China (30970850)and the Ministry of Health Industry Special Scientific Research Project (201202012)


Objective To evaluate the response of 131I therapy and to explore the influencing factors in non-metastatic differentiated thyroid cancer(DTC) patients with preablative stimulated thyroglobulin (ps-Tg) above 10 ng/ml.Methods The study included 157 DTC patients who had undergone total or near total thyroidectomy and subsequent 131I therapy with ps-Tg>10 ng/ml,and they were divided into 3 groups as excellent response(ER,49 cases),acceptable response (AR,36 cases),and incomplete response(IR,72 cases) according to the response to 131I therapy. We compared the clinicopathologic features and ps-Tg levels among 3 groups,as well as ps-Tg levels between IR and non-IR groups. The ROC curve was employed to evaluate the predictive value of ps-Tg levels in 131I therapy responses. Results The three groups showed significant difference in ps-Tg levels(H=35.142,P<0.001),gender(χ2=6.82,P=0.033),extrathyroid invasion(H=31.380,P<0.001),and lymph metastases(H=14.375,P=0.001). The ps-Tg level in IR is higher than that in non-IR(U=1384.5,P<0.001),while it was not significantly different between ER and AR(U=771.5,P=0.326).The diagnostic critical point(DCP) of ps-Tg to differentiate IR and non-IR was 28.3 ng/ml(sensitivity 57.5%,specificity 87.1%),with a corresponding area under the ROC curve(AUC) of 0.774 (95%CI:0.701-0.847). Conclusions Near-half(45.86%) non-metastatic DTC patients with ps-Tg above 10 ng/ml are more susceptible to IR. The level of ps-Tg>28.3 ng/ml may be a useful and sensitive diagnostic marker for predicting incomplete response.

Key words: differentiated thyroid cancer, thyroglobulin, 131I therapy

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