| Objective:1.Retrospectively analysis the clinicopathological characteristics of thepreoperative hematogenous metastasis DTC patients and postoperative hematogenousmetastasis DTC patients,and in the meanwhile make a contrast of the curative efficacyof131I therapy in treating the preoperative and postoperative hematogenous metastasispatients.2.Perform univariate logistic regression analysis and multiple logisticregression analysis to explore the factors that may affect the curative efficacy of131Itherapy in the preoperative and postoperative hematogenous metastasis patients andprovide referrence value for the future131I treatment in hematogenous metastasis ofDTC.Methods:59patients who have been diagnosed with thyroid cancer and beenmanaged with primary surgery and131I therapy in the first Affiliated Hospital ofFujian Medical University from2006.01.01to2012.12.31are included in thisstudy.Make a contrast of the clinicopathological characteristics between thepreoperative hematogenous metastasis group and the postoperative hematogenousmetastasis group,and compare the difference of curative effective rate of131I therapybetween the preoperative and postoperative hematogenous metastasisgroups.Afterwards perform univariative logistic regression analysis and multiplelogistic regression analysis to explore the factors which may affect the curativeefficacy of131I therapy in the preoperative and postoperative hematogenous metastasispatients.Finally make a preliminary inductive analysis of common side effects of131Itherapy in treating the DTC hematogenous metastasis patients.Results:1.Based on the diagnostic criterion for preoperative and postoperativehematogenous metastasis,34cases(57.6%) are classified into the preoperative groupand25cases(42.4%) into the postoperative group.2.There are no significantdifferences(P>0.05) on patients’ gender,age, metastatic region, histological type,histological invasive characteristics between the two groups while there is a significant difference on the131I uptake rate of metastatic sites between the twogroups (P=0.006); The overall curative effective rate of131I therapy is57.6%and thenoneffective rate is42.4%.The curative effective rate of the preoperative group andpostoperative group is44.1%and76.0%respectively and there is a significantdifference(p=0.014).3.The univariate logistic regression analysis shows that in thepreoperative group, the effective rate of131I therapy in treating the preoperativehematogenous metastasis cases is correlated with the131I uptake rate of metastaticsites and the prior treatment Tg level of the patient while is uncorrelated with age,gender, histological type and histological invasive characteristics; In thepostoperative group, the effective rate of131I therapy in treating the postoperativehematogenous metastasis cases is merely correlated with metastatic regions and the131I uptake rate of metastatic sites.4. The multivariate logistic regression analysisdemonstrates that metastatic regions and the131I uptake rate of metastatic sites areindependent factors affecting the effective rate of131I therapy in treating thepreoperative and postoperative hematogenous metastasis cases,precluding otherconfounding factors.5.The incidence rate of side effects of131I therapy is low.Conclusion:There are no significant differences on the clinicopathological featuresbetween the DTC preoperative metastatized group and postoperative metastatizedgroup.The131I therapy has good clinical curative effects in treating the DTChematogenous metastasis patients and is better in the postoperative group than in thepreoperative group.Metastatic regions and the131I uptake rate of the metastatic sitesare independent definite factors affecting the effect rate of131I therapy in treating thehematogenous metastasis patients.Only the lung-metastatized cases and having higher131I uptake rates will achieve a better clinical curative effect.The131I therapy is arelatively safer method in treating the DTC hematogenous metastasis patients. |
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