Effect Of Autoimmune Diseases On Differentiated Thyroid Cancer Patients After ¹³¹I Therapy

ObjectiveTo investigate the influence of lymph node metastasis on the change of positive thyroglobulin antibody?TgAb?in differentiated thyroid carcinoma after initial treatment.MethodsWe retrospectively analyzed the clinical data of 98 papillary thyroid carcinoma patients with positive TgAb??115 IU/ml?before radioiodine?RAI?therapy,all of whom underwent total or near total thyroidectomy,neck lymph node dissection and subsequent RAI therapy.Patients were divided into negative Group?n=83?and non-gegative Group?n=15?according to the disappearance of positive TgAb or not after a mean follow-up of 21.0 months.Analysis of variance,?2 test and Mann-Whitney rank-sum test were applied to compare the basic clinical features between G1 and G2,including number of metastatic lymph nodes,lymph node metastasis rate and node-stage,dose of RAI ablation,etc.The receiver operating characteristic curves were employed to evaluate the predictive values of TgAb levels?negative or positive?and optimal cut-off point.The multivariate analyses were further performed to explore the independent indicator for persistent positive TgAb.Results1.Compared with negative group,the proportion of N1 a and N1 b in non-negative group was significantly higher,with no N0?Fisher's Exact Test,P=0.032?,and the median metastatic lymph node rate was also higher in non-negative group?Mann-Whitney U=-3.498,P=0.00?.2.The cut-off value for metastatic lymph node rate to predicting disappearance of positive TgAb was 24%,with sensitivity of 71.4%.3.In the negative group,the rate of decrease of TgAb in N1 a and N1 b was significantly higher than that in non-negative group [27.31 IU / ml / month vs.4.43 IU / ml / month],and all patients in N0 had negative TgAb?Mann-Whitney U,Z =-3.498,P = 0.000?.4.The multivariate analysis showed that only node-stage?OR=3.183,P=0.038?was the independent indicator for persistent positive TgAb.ConclusionNode-stage was an independent indicator for disappearance of positive TgAb.A metastatic lymph node rate of higher than 24% might hold prognostic value in predicting disappearance of positive TgAb.ObjectiveChronic lymphocytic thyroiditis?CLT?is a common autoimmune inflammation.The aim of this present study was to determine the relationship between CLT and the response of patients with differentiated thyroid carcinoma?DTC?who received surgery and radioactive iodine-131(¹³¹I)treatment for thyroid carcinoma.MethodsRetrospectively analyzed 128 patients who received initial treatment for thyroid disease at Pecking Union medical college hospital from 2014-2016.Of this participants,with histologically confirmed DTC were analysed according to the present?CLT1?or absent?CLT0?concurrent CLT.One-way analysis,chi-square test and rank-sum text,Mann-White test and multivariate analyses were used to evaluate the statistic of clinicopathological features.Correlation analysis were conducted between response to 131 I and present or absent concurrent CLT.The response was evaluated between two groups according to 2015 ATA response system.Results1.Of 128 patients,smaller tumors size with presentation and a greater female preponderance were noted in patients with CLT compared with those without CLT?P=0.011,P=0.028,respectively?.There were no significant different in age,multifocal,stages of lymph nodes,capsular invasion and TNM classification system for DTC,during 24-month mean fellow-up period.2.There was no significant different in response between two groups.The Excellent Response?ER?was 72.7%?40/55?and 68.5%?50/73?,respectively.Indeterminate Response,?IR?was 14.5%?8/55?and 13.7%?10/73?,respectively.Biochemical Incomplete Response,?BIR?was 3.6%?2/55?and 6.8%?5/73?,respectively.Structural Incomplete Response,?SIR?was 9.1%?5/55?and 10.9%?8/73?,respectively.3.Meanwhile,there was no correlation between response and two groups?P=0.591?.4.There was no significant difference in thyroglobulin antibody?TgAb?between the two groups after treatment?P=0.0766?,but the CLT1 group showed a significant decrease?59.17% VS 24.76%?compared with CLT0 group.Conclusions1.Our results do not support CLT is associated with a well response after 131 I treatment for DTC patients.2.TgAb levels of DTC patients with the CLT showed a significant downward trend after 131 I treatment.