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Objective · To investigate the curative efficacy and influential factors of 131I treatment for pulmonary metastases from differentiated thyroid carcinoma (DTC). Methods · A total of 95 DTC patients (33 males and 62 females) with pulmonary metastasis who underwent 131I treatment in Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, from April 2012 to May 2016 were retrospectively analyzed. The efficacy of 131I treatment was assessed using determination of serum thyroglobulin level and 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (～ (18) F-FDG PET/CT). The possible factors affecting efficacy included gender, age, pathological classification, wheteer pulmonary metastasis diagnosed before treatment, the iodine and 18F-FDG uptake of pulmonary lesions, the size and number of lung lesions, extrapulmonary distant metastasis.Univariate analysis was performed using Rank test and χ2 test, the critical value was obtained through receiver operating characteristic (ROC) curve and Logistic regression was also performed. Results · The rates of efficacy and inefficacy of 131I treatment were 53.68％ and 46.32％, respectively. Univariate analyses showed that maximum standardized uptake value (SUVmax) evaluated by 18F-FDG PET/CT (P=0.004), the size of lung metastases (P=0.000), age＜45 years (P=0.004), 131I uptake (P=0.022), whether pulmonary metastasis diagnosed before treatment (P=0.000), extrapulmonary distant metastasis (P=0.014) were the factors influencing outcome of 131I treatment. The critical value of 18F-FDG uptake for patients obtained by ROC curve was 1.45 (sensitivity of 56.8％ and specificity of 76.5％) and the critical value of lung lesion diameter was 9.63 mm (sensitivity of 43.2％ and specificity of 88.2％). Multivariate Logistic regression analysis showed that the influential factors included the age of patients, the size and 18F-FDG SUVmax of lung metastases and whether pulmonary metastasis diagnosed before treatment. Conclusion · 131I treatment is an effective method for pulmonary metastases from DTC. The patients aged less than 45 years, with the lung lesion size less than 9.63 cm, low 18F-FDG SUVmax and diagnosed before treatment may have good response to 131I treatment.
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Objective To investigate the changes of iodide uptake and the expression of thyroidspecific genes in poorly differentiated follicular thyroid carcinoma (FTC) cells after transfection of human TSH receptor (hTSHR) gene in vitro. Methods The recombinant eukaryotic expression plasmid PcDNA3. 1/hTSHR-cDNA was transformed into DH5a bacterial for amplification and then the recombinant plasmid was extracted. The recombinant was identified with PCR amplifying, restriction enzyme digestion analysis and DNA sequencing. The recombinant plasmid pcDNA3.1/hTSHR was transfected into FTC-133 cell line by lipofectin methodin vitro. Immunofluorescence, iodide uptake studies and real time-PCR were applied to detect target protein expression. Statistical analysis was performed with t-test using SPSS 13. 0 software. Results Kpn Ⅰ and Xba Ⅰ restriction enzyme digestion, PCR amplifying and DNA sequencing confirmed that pcDNA3. 1/hTSHR was successfully constructed. After transfection of the recombinant plasmid pcDNA3. 1/hTSHR-cDNA and the stimulation of hTSH, the tumor cells displayed the expression of hTSHR protein at cell surface and cytoplasm. The iodine uptake in pcDNA3. 1/hTSHR transfected cells was 2. 9 times higher than that of control(pcDNA3.1(+) transfected cells) group(t = 28.63, P ＜0. 01). The expression of TSHR,NIS, TPO and Tg (mRNA levels) in pcDNA3. 1/hTSHR transfected cells were also significantly elevated by 1.74 (t =5.959, P＜0.01), 7.2 (t =3.807,P＜0.05), 2.88 (t=4.769,P＜0. 01) and 2.67 times (t=6.388,P ＜0.01) respectively compared to those of the control group. Conclusion The study demonstrates that iodide uptake may be reactivated by hTSHR receptor gene transfection in poorly differentiated FTC cell.
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Objective To investigate the clinical value of ~(99)Tc~m-ethylenedicysteine (EC) diuretic renography (DR) in pre-and post-operative pediatric congenital hydronephrosis.Methods The DR with injection of Furosemide at 15 min of forty children with hydronephrosis was retrospectively studied.The preoperative renal blood perfusion rate (BPR),effective renal plasma flow (ERPF),grade of hydronephrosis,renogram and renal dynamic imaging of pre- and post-operative kidneys were compared.The t-test and Mann-Whitney test were used for data analysis.Results (1) Of 40 pathological kidneys,the BPR increased 5.99% (t=-5.13,P＜0.01)from pre-operative to post-operative:(34.05±11.07)% to (40.04±8.56)%.The ERPF increased 12.48 ml/min(t=-4.35,P＜0.01) from pre-operative to post-operative:(57.81±34.32)ml/min to(70.29±5.37)ml/min.(2)The grade of hydronephrosis of 40 pathological kidneys improved significantly(Z=-2.64,P＜0.01) with the mean sum of ranks of 47.21 pre-operatively to 33.79 post-operatively.(3) As the hydronephrosis worsened,the collecting system became bigger,the renal parenchyma became thinner,the extent of intrarenal parenchymal photopenia became larger and the response to diuretic challenge in pathological kidneys decreased or became totally irresponsive.(4)Thirty-seven cases of obstruction at ureteropelvic junction (UPJO) and 3 cases at ureterovesical junction (UVJO) were diagnosed by DR,which were all confirmed by surgery.Conclusions DR is a reliable method to evaluate pediatric congenital hydronephrosis.It can accurately reflect the grade and (or) severity of the disease,guide therapy and assess the therapeutic success of operation.
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Objective To evaluate the value of lymphoscintigraphy in diagnosis of chylous ascites in children.Methods Lymphoscintigraphy was done in 6 cases,computed tomography(CT) was done in 4 cases,X-ray exam was done 42 times.And their video repore were compared.Results Lymphoscintigraphy was done in 6 cases,5 cases′ results were positive which diagnosed chylous ascites,and their leaking positions were also found.Conclusion Lymphoscintigraphy has the qualitative and orientational effect on diagnosis of children with chylous ascites.