刺激和非刺激甲状腺蛋白在差异化甲状腺癌中的预后值的比较:一项回顾性研究
Junik Son1, Chae Moon Hong1, Do-Hoon Kim1
1Department of Nuclear Medicine, Kyungpook National University Hospital, 130 Dongdeok-Ro, Jung Gu, Daegu, Republic of Korea 41944.
Nuclear medicine and molecular imaging
|November 20, 2023
概括
与TSH刺激型甲状腺蛋白对治疗的反应 (stiRTT) 相比,与非刺激型甲状腺蛋白对治疗的反应 (nonstiRTT) 相比,对差异化甲状腺癌无复发生存的预后价值更高. 然而,对于在初始和第二次非强度RTT评估中反应良好的患者,第二次stiRTT可能不需要.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 医学诊断 医学诊断 医学诊断
背景情况:
- 差异化甲状腺癌 (DTC) 发病率正在上升,需要可靠的预后因素来管理患者.
- 对治疗反应 (RTT) 的准确评估对于指导DTC患者的随访和治疗决策至关重要.
研究的目的:
- 为了评估RTT的预后意义,使用TSH刺激型thyroglobulin (sti-Tg) 和非刺激型thyroglobulin (nonsti-Tg).
- 确定基于非sti-Tg的RTT (nonstiRTT) 是否可以取代基于sti-Tg的RTT (stiRTT) 以改善患者的生活质量.
主要方法:
- 分析了419名接受全甲状腺切除和放射性 (RAI) 治疗的DTC患者.
- 最初和第二次RTT评估是在RAI后6-24个月进行的,不包括结构性不完整的响应.
- 无复发生存期 (RFS) 通过对stiRTT和非stiRTT的日志等级测试进行统计分析.
主要成果:
- 最初的stiRTT和非stiRTT都显著预测了RFS (p<0.0001),stiRTT显示出优异的预测准确性.
- 第二次RTT评估显示,RFS仅与stiRTT (p<0.0001) 具有统计意义.
- 在初始stiRTT有优异反应 (ER) 的患者与第二次stiRTT或第二次非stiRTT也有ER之间没有观察到显著的RFS差异.
结论:
- 在DTC中,stiRTT的预测能力在初始和随后的RTT评估中都超过非stiRTT的预测能力.
- 对于在初始stiRTT上取得优异反应的患者,如果在第二次非stiRTT评估上也显示出优异反应,则第二次stiRTT评估可能是多余的.
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