2015 年第 4 期 第 13 卷

100例分化型甲状腺癌术后131I治疗的疗效评价

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关键词：分化型甲状腺癌131I

• 摘要：
• 【摘要】目的 探讨131I在分化型甲状腺癌（DTC）术后清除残余甲状腺和转移病灶的疗效及安全性。方法 随机抽取2012年4月至2013年12月在我院行131I清甲及清灶治疗的100例分化型甲状腺癌患者。治疗前3-4周停服L-T4，所有患者均予以131I（3.0~5.6）×102 MBq清甲治疗，治疗后口服L-T4替代治疗，6个月复查，根据颈部超声、全身显像及血清Tg水平评价131I治疗的效果。结果 本组患者接受1~3次131I治疗，共140个疗程，平均每次治疗剂量为4.03×102 MBq，1次清甲成功率67%，2次131I治疗成功率92%，131I治疗后Tg转阴率53.3％；131I治疗后5例出现一过性白细胞下降，治疗前后肝肾功能无明显改变。结论 近年来随着DTC的发病率及诊断率的升高，DTC的患病率快速升高，手术切除甲状腺后尽早进行规范131I治疗，治疗次数少，清甲成功率高且副反应小，对预防复发起到重要的作用。
• Objective To discuss the efficacy and safety of 131I clearance of differentiated thyroid carcinoma (DTC) postoperative residual thyroid tissue and metastatic lesion. Method Extract randomly100 DTC patients received 131I clearance of DTC postoperative residual thyroid tissue and metastatic lesion in our hospital randomly from 2012 April to 2013 December. Stop taking L-T4 3-4 weeks before the treatment, all patients were treated by 131I （3.0~5.6）×102 MBq clearance postoperative residual thyroid tissue therapy, taking L-T4 pills after the treatment, rechecking 6 month later taking and evaluating the 131I treatment effect according to the result of neck ultrasonography, whole-body radioiodine scan and serum Tg. Result This group of patients received 1-3 times of 131I treatment. 140 treatment courses are given totally. The average dose of each treatment is 4.03×102 MBq Success rates are 67% and 92%for once and twice treatment respectively. The negative conversion rate of Tg is 53.3%. Conclusion In recent years, the DTC incidence rate and diagnosis rate has increased. Early specification using of the 131I treatment has benefit to increase the cure rate, reduce the number of treatments and has important effect of prevention of recurrence after surgical removal of the thyroid.