Zhongguo quanke yixue (May 2024)

Efficacy Analysis of 131I Therapy in Serum Thyroglobulin Antibody Positive Differentiated Thyroid Carcinoma with Distant Metastasis

  • BAI Xin, WU Xinyu, ZHAO Zun, LIU Shuxin, LIU Simiao, XUE Yuhang, XU Junling, GAO Yongju

DOI
https://doi.org/10.12114/j.issn.1007-9572.2023.0705
Journal volume & issue
Vol. 27, no. 15
pp. 1833 – 1837

Abstract

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Background Differentiated thyroid carcinoma (DTC) with distant metastasis generally forecasts a poor prognosis. Timely diagnosis and effective treatment of distant metastasis are pivotal and challenging in clinical practice. Serum thyroglobulin (Tg) is a marker for monitoring tumor residue or recurrence/metastasis post-surgery and post-131I therapy in DTC. Thyroglobulin antibodies (TgAb) are autoantibodies against Tg that can potentially interfere with Tg measurement. Presently, literature on 131I treatment of TgAb positive DTC with distant metastasis is sparse. Objective To investigate the efficacy of 131I therapy in TgAb positive DTC with distant metastasis. Methods A retrospective analysis was conducted on clinical data of 189 DTC patients treated with 131I from January 2017 to January 2022 at the People's Hospital of Zhengzhou University. Pre-treatment and follow-up measurements of thyroid-stimulating hormone (TSH), Tg, and TgAb were collected. Patients were categorized into TgAb positive (29 cases) and TgAb negative (160 cases) groups. The efficacy of 131I therapy was evaluated. Serum thyroid hormones and routine blood tests were conducted 6-8 weeks post-131I therapy, followed by biannual or annual follow-ups including serum thyroid hormones, Tg, TSH, TgAb, thyroid peroxidase antibodies (TPOAb), neck ultrasound, and CT scans of metastatic sites. Results Statistical significance (P<0.05) was observed in the comparison of distant metastatic sites, TPOAb, and pre-first 131I therapy TgAb levels between the TgAb positive and negative groups. In the TgAb positive group, disease was controlled in 14 patients (48.2%), while 15 patients (51.8%) showed disease progression; in the TgAb negative group, 127 patients (79.4%) showed disease control and 33 patients (20.6%) showed progression. The rate of disease progression in the TgAb positive group was significantly higher than in the TgAb negative group (χ2=7.148, P=0.008) . Conclusion The rate of disease progression in serum TgAb positive DTC with distant metastasis is significantly higher than in TgAb negative patients; differences in metastatic sites, TPOAb, and pre-first 131I therapy TgAb levels were observed between the groups.

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