Analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131I treatment

Background and purpose: Lymph node metastasis (LNM) is the most common metastasis of differentiated thyroid cancer (DTC), and the efficacy of 131I on LNM is controversial. The aim of this study was to clarify the efficacy of 131I on LNM with good iodine uptake and the influencing factors. Methods: I...

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Main Author: MEI Xiaoran, FENG Fang, WANG Hui, WEI Zhixiao
Format: Article
Language:English
Published: Editorial Office of China Oncology 2022-11-01
Series:Zhongguo aizheng zazhi
Subjects:
Online Access:http://www.china-oncology.com/fileup/1007-3639/PDF/1670982861717-1300138444.pdf
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author MEI Xiaoran, FENG Fang, WANG Hui, WEI Zhixiao
author_facet MEI Xiaoran, FENG Fang, WANG Hui, WEI Zhixiao
author_sort MEI Xiaoran, FENG Fang, WANG Hui, WEI Zhixiao
collection DOAJ
description Background and purpose: Lymph node metastasis (LNM) is the most common metastasis of differentiated thyroid cancer (DTC), and the efficacy of 131I on LNM is controversial. The aim of this study was to clarify the efficacy of 131I on LNM with good iodine uptake and the influencing factors. Methods: In this study, 161 iodine positive metastasis lymph nodes from 90 DTC patients treated by 131I from January 2015 to June 2019 in Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine were included, and the clinical and imaging data of the patients were analyzed. SPSS 24.0 software was used to make statistical analysis. The measurement data were distributed according to the normal distribution, then the independent sample t-test was compared. The comparison of the counting data was conducted by χ2 test, and the multivariate analysis was carried out by logistic regression analysis. The receiver operating characteristic (ROC) curve between multiple quantitative indexes and the failure of 131I treatment were established, and the optimal diagnostic threshold was obtained. Results: Among 161 iodine positive metastasis lymph nodes, 71 (44.10%) were effective, and 90 (55.90%) were ineffective. Univariate analysis showed that there were significant differences in age, gender, pathological type, number of primary lesions, location of primary lesions, distant metastasis and serum thyroglobulin (Tg) level between the two groups (P<0.05). Multivariate logistic regression analysis showed that the pathological types (OR = 11.827, 95% CI: 1.128-123.978, P = 0.039), distant metastasis (OR = 0.220, 95% CI: 0.093-0.522, P = 0.001) and number of primary lesions (OR = 0.421, 95% CI: 0.212-0.837, P = 0.014) were closely related to the outcome of the treatment. Conclusion: Multiple primary foci, papillary thyroid carcinoma (PTC), distant metastasis, serum Tg higher than 43.51 ng/mL and the maximum diameter of metastatic lymph nodes greater than 16.8mm are the risk factors of ineffective 131I treatment. Increasing the treatment dose or choosing surgical resection as soon as possible is recommended for those patients.
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spelling doaj.art-b8a198ed80844d768b3c8062675ff75d2023-02-09T00:25:45ZengEditorial Office of China OncologyZhongguo aizheng zazhi1007-36392022-11-0132111091109710.19401/j.cnki.1007-3639.2022.11.007Analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131I treatmentMEI Xiaoran, FENG Fang, WANG Hui, WEI Zhixiao01. Department of Nuclear Medical, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China;2. Department of Nuclear Medical, Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai 200092, ChinaBackground and purpose: Lymph node metastasis (LNM) is the most common metastasis of differentiated thyroid cancer (DTC), and the efficacy of 131I on LNM is controversial. The aim of this study was to clarify the efficacy of 131I on LNM with good iodine uptake and the influencing factors. Methods: In this study, 161 iodine positive metastasis lymph nodes from 90 DTC patients treated by 131I from January 2015 to June 2019 in Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine were included, and the clinical and imaging data of the patients were analyzed. SPSS 24.0 software was used to make statistical analysis. The measurement data were distributed according to the normal distribution, then the independent sample t-test was compared. The comparison of the counting data was conducted by χ2 test, and the multivariate analysis was carried out by logistic regression analysis. The receiver operating characteristic (ROC) curve between multiple quantitative indexes and the failure of 131I treatment were established, and the optimal diagnostic threshold was obtained. Results: Among 161 iodine positive metastasis lymph nodes, 71 (44.10%) were effective, and 90 (55.90%) were ineffective. Univariate analysis showed that there were significant differences in age, gender, pathological type, number of primary lesions, location of primary lesions, distant metastasis and serum thyroglobulin (Tg) level between the two groups (P<0.05). Multivariate logistic regression analysis showed that the pathological types (OR = 11.827, 95% CI: 1.128-123.978, P = 0.039), distant metastasis (OR = 0.220, 95% CI: 0.093-0.522, P = 0.001) and number of primary lesions (OR = 0.421, 95% CI: 0.212-0.837, P = 0.014) were closely related to the outcome of the treatment. Conclusion: Multiple primary foci, papillary thyroid carcinoma (PTC), distant metastasis, serum Tg higher than 43.51 ng/mL and the maximum diameter of metastatic lymph nodes greater than 16.8mm are the risk factors of ineffective 131I treatment. Increasing the treatment dose or choosing surgical resection as soon as possible is recommended for those patients.http://www.china-oncology.com/fileup/1007-3639/PDF/1670982861717-1300138444.pdf|differentiated thyroid cancer|iodine positive|lymph node metastasis|efficacy analysis
spellingShingle MEI Xiaoran, FENG Fang, WANG Hui, WEI Zhixiao
Analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131I treatment
Zhongguo aizheng zazhi
|differentiated thyroid cancer|iodine positive|lymph node metastasis|efficacy analysis
title Analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131I treatment
title_full Analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131I treatment
title_fullStr Analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131I treatment
title_full_unstemmed Analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131I treatment
title_short Analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131I treatment
title_sort analysis of therapeutic response of iodine positive metastasis lymph nodes in differentiated thyroid cancer after 131i treatment
topic |differentiated thyroid cancer|iodine positive|lymph node metastasis|efficacy analysis
url http://www.china-oncology.com/fileup/1007-3639/PDF/1670982861717-1300138444.pdf
work_keys_str_mv AT meixiaoranfengfangwanghuiweizhixiao analysisoftherapeuticresponseofiodinepositivemetastasislymphnodesindifferentiatedthyroidcancerafter131itreatment