Influencing factors of therapeutic effects of 131I re-ablation treatment on differentiated thyroid cancer
Objective To explore the predictive value of the clinical indicators including tumor size and tumor multifocality,preab-lative stimulated thyroglobulin(ps-Tg)level before the initial 131I ablation,stimulated thyroglobulin(s-Tg)level,and s-Tg/supressed thyroglobulin(sup-Tg)of differentiated thyroid cancer(DTC)patients for poor curative effect of 131I re-ablation.Methods A total of 162 DTC patients who underwent total thyroidectomy and retreatment with 131I ablation in the Affiliated Hospital of Xuzhou Medical Univer-sity from June 2017 to January 2021 were selected and divided into excellent response(ER)group,indeterminate response(IDR)group,biochemical incomplete response(BIR)group and structural incomplete response(SIR)group according to the Guidelines for Radioiodine Therapy of Differentiated Thyroid Cancer(2021 edition).The differences in clinical characteristics including age,gender,tumor size,and tumor multifocality,and serological indicators including ps-Tg level,s-Tg level,and s-Tg/sup-Tg were analyzed between the groups.ER and IDR groups were defined as satisfactory curative effect group,and BIR and SIR groups were as poor curative effect group.Receiver operating characteristic(ROC)curves were used to evaluate the values of ps-Tg level,s-Tg level,and s-Tg/sup-Tg for predicting poor curative effect of 131I re-ablation in DTC patients.Results Gender,age,tumor multifocality,tumor size,and the ratio of first 131I dose to total 131 I dose in DTC patients were not the influencing factors for the efficacy of 131 I re-ablation(all P＞0.05).The serological indica-tors including ps-Tg,s-Tg,and s-Tg/sup-Tg were significantly different among four groups(all P＜0.05).The ROC curves of ps-Tg,s-Tg,and s-Tg/sup-Tg for predicting the poor efficacy of 131I re-ablation in DTC patients showed that the areas under the curves were 0.825,0.941,and 0.809,the best diagnostic cut-off points were 21.24 μg/L,8.42 μg/L,and 7.87,the corresponding Youden indices were 0.570,0.770,and 0.509,the sensitivities were 76.2％,95.2％,and 76.2％,and the specificities were 80.8％,82.8％,and 74.7％,respectively.Conclusions ps-Tg level,s-Tg level,and s-Tg/sup-Tg have certain predictive value for the efficacy of 131I re-ablation in DTC patients.
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