Analysis of risk factors for recurrence of differentiated thyroid carcinoma after surgical resection combined with iodine-131 and TSH suppression therapy / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the risk factors of recurrence after surgical resection of differentiated thyroid carcinoma combined with iodine-131 and TSH（Thyroid stimulating hormone） inhibition therapy. Methods:From January 2015 to April 2020, the clinical data of patients with structural recurrence and without recurrence were retrospectively collected after surgical treatment combined with iodine-131 and TSH inhibition therapy in the First Medical Center of PLA General Hospital. The general conditions of the two groups of patients were analyzed and the measurement data in line with the normal distribution was used for comparison between groups. For measurement data with non-normal distribution, the rank sum test was used for inter-group comparison. The Chi-square test was used for comparison between the counting data groups. Univariate and multivariate regression analyses were used to determine the risk factors associated with relapse. Results:The median follow-up period was 43 months（range 18-81 months） and 100 patients（10.5%） relapsed among the 955 patients. Univariate analysis showed that tumor size, tumor multiple, the number of lymph node metastases>5 in the central region of the neck, and the number of lymph node metastases>5 in the lateral region were significantly correlated with post-treatment recurrence（P<0.001, P=0.018, P<0.001, P<0.001）. Multivariate analysis showed that tumor size（adjusted odds ratio OR: 1.496, 95%CI: 1.226-1.826, P<0.001）, tumor frequency（adjusted odds ratio OR: 1.927, 95%CI: 1.003-3.701, P=0.049）, the number of lymph node metastases in the central neck region>5（adjusted odds ratio OR: 2.630, 95%CI: 1.509-4.584, P=0.001） and the number of lymph node metastases in the lateral neck region>5（adjusted odds ratio OR: 3.074, 95%CI: 1.649-5.730, P=0.001） was associated with tumor recurrence. Conclusion:The study showed that tumor size, tumor multiple, the number of lymph node metastases in the central region of the neck>5 and the number of lymph node metastases in the side of the neck >5 are independent risk factors for recurrence of differentiated thyroid cancer after surgical resection combined with iodine-131 and TSH inhibition therapy.

Comparison of short-term effects between interventional embolization treatment and iodine-131 therapy for Graves' hyperthyroidism / 介入放射学杂志

Objective To compare the short-term effects between interventional arterial embolization and iodine-131 therapy in treating Graves'disease.Methods A total of 84 patients with Graves'disease (GD),confirmed by clinical data and laboratory tests,were divided into two groups:interventional group(n=42)receiving arterial embolization and iodine-131 group(n=42)receiving iodine-131 therapy.Before and after the treatment thyroid angiography and SPECT/CT imaging were performed to determine the shape and size of the thyroid,and radioimmunoassay method was used to measure serum levels of FT3,VF4,TSH and TRAb at 3.6 and 12 months after the therapy.The results were compared and statistically analyzed.The occurrence of complications was observed. Results No statistically significant difference in short-term therapeutic effects was found between interventional group and iodine-131 group.The occurrence of early severe complication was much higher in interventional group than that in iodine-131 group,while the occurrence of hypothyroidism was obviously higher in iodine-131 group than that in interventionai group.Conclusion Both interventional embolization and iodine-131 therapy have reliable effect for the treatment of Graves'disease.Iodine-131 therapy may be used in patients who plan to receive initial treatment or in patients who failed to effectively respond to other kinds of therapies,while interventional embolization may be employed in patients who are not able to receive surgery or in patients who have failed to respond to antithyroid drug treatment,or in patients whose iodine-131 intake rate is too low to undergo iodine-131 therapy,especially in patients with refractory and intractable hyperthyroidism. Interventional embolization can be regarded as an alternative treatment for Graves'disease.

Metastatic Follicular Thyroid Carcinoma to the Thymus in a 35-year-old Woman

Clinically detectable metastatic follicular thyroid carcinoma to the thymus is very rare in the literature and sometimes confused with false positive uptake of Iodine