The value of combined detection of peripheral blood double negative T cells,natural killer T cells and serum pre-treatment stimulative Tg in predicting the response to 131I treatment in differentiated thyroid carcinoma
Objective To investigate the value of peripheral blood double-negative T cells(DNT),natural killer T cells(NKT)and pre-treatment stimulative Tg(ps-Tg)in predicting 131I response after surgery for differentiated thyroid cancer(DTC).Methods A to-tal of 215 postoperative DTC patients who received 131I treatment in the Department of Laboratory Medicine of No.960th Hospital of the PLA Joint Logistics Support Force from January to December 2018 were selected as the study objects.According to the 2015 American Thyroid Society guidelines,the patients were divided into excellent response(ER)group(n=121),indeterminate response(IDR)group(n=59)and incomplete respmse(IR)group(n=35).Patients were divided into recurrence group(n=17)and no recurrence group(n=198)according to the recurrence situation within 1 year.The differences in gender,age,lymph node metastasis and TNM stage among different therapeutic groups were compared.The difference of DNT percentage,NKT percentage and ps-Tg level in periph-eral blood after DTC was compared between different therapeutic effect groups and different clinical outcome groups.Mann-Whitney U rank sum test was used to analyze the relationship between DNT,NKT and ps-Tg levels and clinical outcomes in the ER group after 131I treatment,and receiver operating characteristic(ROC)curve and optimal cut-off point were used to evaluate the predictive value of each indicator alone and combined detection for optimal treatment response.Results There was no significant difference in gender and age between ER group,IDR group and IR group(P>0.05).There were significant differences in lymph node stage and TNM stage(P<0.05).DNT percentage and NKT percentage in IDR and IR groups were higher than those in ER group,and ps-Tg in IR group was higher than those in IDR and ER group,with statistical significance(P<0.05).DNT percentage and ps-Tg level in relapsing group were higher than those in non-relapsing group,with statistical significance(P<0.05).There was no significant difference in NKT percentage between the two groups(P>0.05).DNT and ps-Tg had high predictive values for the optimal treatment response ER[area under the curve(AUC)was 0.748 and 0.776,respectively],and the cut-off points are 7.15％and 8.44 ng/ml,respective-ly.There was no significant difference in sensitivity and specificity between the two detection indexes(P>0.05).The combined value of the three measures was the highest(AUC=0.844,sensitivity 93.6％,specificity 66.6％).Conclusion DNT percentage and NKT percentage before 131I postoperative treatment can predict clinical outcome,and the increase of DNT and NKT may indicate poor prog-nosis and high risk of recurrence.DNT and ps-Tg alone have the same efficacy in predicting the best treatment response,and the com-bined detection of DNT,NKT and ps-Tg can achieve a high value in predicting the best treatment response.
Differentiated thyroid carcinoma131I therapyDouble negative T cellsNatural killer T cellsPreablative stim-ulated thyroglobulin
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