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)

Abstract:

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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