The ¹³¹I Radiotherapy Effect And Prognosis Of DTC Complicated By Abnormal Thyroid Autoimmunity

Tg has the value of to be a tumor marker of diagnosis and monitoring the recurrence or metastasis of DTC after thyroidectomy,but the existence of Tg Ab is the most serious factor that interfere with the value.In recent years,the questions of how to consider and deal with the high level of serum Tg Ab and whether Tg Ab could serve as a surrogate marker of disease in the surveillance of patients with DTC suffered surgery in the case of Tg negative are hot issues.Meanwhile,Tg Ab is widely recognized as an important marker in the process of thyroid autoimmunity,its abnormal increase is usually found in patients with AITD,especially with HT.As the autoantibody specific for thyroid,the emergency of Tg Ab reflects the immune dysfunction.Meanwhile,there are intricate relationships in the occurrence,development and prognosis of the coexistence of AITD and DTC.Therefore,we investigate the relationships among the evaluated Tg Ab, AITD and 131 I radiotherapy effect and prognosis of DTC patients after thyroidectomy.Part IObjectiveTo evaluate the diagnostic values of TgAb in Tg-negative patients with DTC.Meterials and Methods97 DTC patients in the case of Tg-negative and Tg Ab-positive after hyroidectomy were divided into two groups as M1 and M0 according to whether the patient with recurrence or metastasis or not. Compared Tg Ab levels and the median time for disappearance of Tg Ab after 131 I radiotherapy between M1 and M0.Followed up the patients’ disease states corresponding to the change trend of Tg Ab levels dynamically after 131 I radiotherapy.ResultsBoth the values of TgAb(t=0.275,p=0.784) and the median time for disappearance of Tg Ab(p=0.778) between M1 group and M0 group has no statistically significant difference.Among 45 patients whose Tg Ab were gradually decreased or became negative there were 44(97.8%)patients who were cured or improved on follow-up.While among 26 patients whose Tg Ab were gradually increased or remained persistently high there were 9(34.6%)patients who were ineffective or became worse.ConclusionsValue of Tg Ab can’t diagnose recurrence or metastasis of DTC in the case of Tg-negative;But the change pattern of Tg Ab levels is of vital importance to the treatment effect and prognosis of disease.Part IIObjectiveTo analysis the patients’ prognosis of the coexistence of AITD with DTC.Meterials and Methods132 DTC patients who had undergone thyroidectomy with positive Tg Ab were divided into two groups as A1 and A0 according to whether the patient present with concurrent AITD or not.Compared Tg Ab levels,the incidence of recurrence or metastasis and the median time for disappearance of Tg Ab between the two groups.ResultsThe incidence of the coexistence of AITD with DTC was 63.3% in patients with positive Tg Ab.Value of Tg Ab between the two groups was no statistically significant difference(t=-1.613,p=0.110).The incidence difference of recurrence or metastasis of the two groups was statistically significant(x2=5.297,p=0.021);Median time for disappearance of Tg Ab were 12.75 months and 20.74 months for group A1 and group A0 respectively,the difference was statistically significant(p=0.040).ConclusionsThe existence of elevated levels of TgAb in DTC patients may indicates the coexistence of AITD.DTC patients coexistent with AITD probably have a greater incidence of recurrence or metastasis, while the enhanced thyroid autoimmune reactions may also produce a protective effect on the prognosis of DTC patients.