Analysis on the efficacy and influencing factors of 131I ablation of residual thyroid tissue in patients with thyroid papillary carcinoma

Objectives: To explore the thyroid papillary carcinoma (PTC) in patients with postoperative ¹³¹ I ablation residual thyroid organization analysis of the curative effect and influencing factors.

Methods: Retrospective analysis was performed on 241 PTC patients who undertook ¹³¹I ablation for the first time from March 2012 to September 2016. Bewteen March 2012 and December 2014, 102 patients used radioimmunoassay for thyroglobulin (Tg), and 139 patients used chemiluminescence assay for Tg from January 2015 to September 2016. The serum of 89 patients with thyroid cancer were collected from September to October 2017. Tg was detected by radioimmunoassay and chemical immunoassay.The data of 64 patients were screened according to the measurement range of the two methods, and the formula was obtained: Y (radioimmunoassay) =11.439+2.942log (chemical reflectance assay) was unified, with statistical significance (P=0.042). The formula was used to convert the Tg measured by chemiluminescence from January 2015 to September 2016 into the Tg measured by radioimmunoassay. These patients underwent a ¹³¹I whole body scan (¹³¹I-WBS) for diagnostic follow-up after 6-8 months, and no iodine uptake was observed at the thyroid bed of the neck compared with the surrounding background as the standard for successful removal, which was divided into the completed ablation group and the incompleted ablation group (57 cases. 57cases). Binary logistic regression and χ² test were performent for age (<45y, ≥45y), gender, surgical procedure (total resection of thyroid, thyroid resection), maximum diameter of lesion (<0.5cm,≥0.5cm), number of primary lesions(single, multiple), presence of LN metastasis, the time of the operation from the first ¹³¹I treatment,thyroid stimulating hormone(TSH) and Tg/TSH .

Results: Among 114 PTC patients, the success rate of the first postoperative ablation of thyroid gland was 50.00% (57/114). Single-factor analysis showed that gender(χ²=8.515,P=0.004), number of primary lesions (χ²=4.267,P=0.039), and Tg/TSH before first ablation of thyroid (χ²=5.092, P =0.024) were the influencing factors for the efficacy of the first ¹³¹I thyroid ablation after surgery, and the statistical difference was significant (Table1, P<0.05). Binary logistic regression analysis proved that age, gender,number of primary lesions and Tg/TSH before first ablation of thyroidwere deterministic factors affecting ¹³¹I treatment (Table2, P<0.05).

Conclusions: The formula can be used to convert the Tg measured by chemiluminescence into the Tg measured by radioimmunoassay, which has certain affecation for the clinical treatment of patients with thyroid cancer. Age, gender,number of primary lesions and Tg/TSH before first ablation of thyroid in patients with thyroid papillary carcinoma may be an important factor affecting the efficacy of ¹³¹I ablation.

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