放射性用于甲状腺癌的使用
Megan R Haymart1, Mousumi Banerjee, Andrew K Stewart
1Division of Metabolism, Endocrinology, and Diabetes, Department of Medicine, University of Michigan, Ann Arbor, MI 48109, USA. meganhay@umich.edu
JAMA
|August 18, 2011
概括
放射性用于甲状腺癌的使用从1990年到2008年增加. 它的应用中的大部分变化与医院特定的因素有关,而不仅仅是患者或瘤特征.
科学领域:
- 在瘤学瘤学.
- 核医学是一种核医学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在甲状腺癌治疗中使用放射性 (RAI) 的确切指示存在不确定性.
- 随着时间的推移,RAI的使用模式和影响这些模式的因素尚未得到充分理解.
研究的目的:
- 分析RAI利用在高度差异化的甲状腺癌中的趋势.
- 调查RAI处方实践在医院一级的变化.
- 为了确定与RAI使用相关的患者和医院特征.
主要方法:
- 从美国国家癌症数据库 (1990-2008) 中,对189,219名患有差异化甲状腺癌的患者进行了时间趋势分析.
- 多级建模用于评估影响RAI使用的患者和医院因素 (2004-2008).
主要成果:
- RAI使用量从1990年的40.4%大幅增加到2008年的56.0%.
- 虽然瘤阶段影响了RAI的使用,但仍然存在显著的差异,医院的特点解释了这一变化的很大一部分.
- 医院类型和病例数量与RAI使用有关,无法解释的医院因素占差异的29.1%.
结论:
- 在20多年来,RAI在分化良好的甲状腺癌中的使用增加了.
- 医院之间存在RAI管理的显著差异,主要归因于未测量的医院特定因素.
相关概念视频
Isotopes and Radioisotopes
In the early 1900s, English chemist Frederick Soddy realized that an element could have atoms with different masses that were chemically indistinguishable. These different types are called isotopes — atoms of the same element that differ in mass. Isotopes differ in mass because they have different numbers of neutrons but are chemically identical because they have the same number of protons. Soddy was awarded the Nobel Prize in Chemistry in 1921 for this discovery.
An isotope containing more...
An isotope containing more...
Imaging Studies II: Positron Emission Tomography and Scintigraphy
Positron Emission Tomography (PET) is a medical imaging technique that provides crucial insights into the body's physiological functions at a molecular level. It is an indispensable resource for diagnosing, staging, and monitoring various illnesses, notably cancer, neurological disorders, and cardiovascular conditions.
Fundamental Principles of PET
Fundamental Principles of PET
Synthesis and Regulation of Thyroid Hormones
Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The iodine is then...
Hyperthyroidism I: Introduction
Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
Hyperthyroidism II: Pathophysiology
Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
Goiter
Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...


