Clinical efficacy and complications of surgical resection combined with 131I therapy in elderly patients with differentiated thyroid cancer / 中华地方病学杂志

ABSTRACT

Objective:To study the clinical efficacy of surgical resection combined with iodine-131 ( 131I) therapy in elderly patients with differentiated thyroid cancer and its influence on complications. Methods:Totally 82 elderly patients with differentiated thyroid cancer who were admitted to Chengde Central Hospital from March 2019 to March 2021 were selected and divided into observation group (41 cases) and control group (41 cases) according to the random number table. The control group underwent total thyroidectomy + neck lymph node dissection, and the observation group was treated with 131I after the operation on the basis of the control group. The indicators in the two groups were evaluated (postoperative observation time cutoff was 3 months), including perioperative indexes, postoperative complications, Karnofsky (KPS) score, serum levels of lymphocyte activating gene-3 (LAG-3) and recombinant human Dick-kopfx related protein-1 (DKK-1) before and after treatment, and the efficacy. Results:There was no significant difference between the two groups in the amount of intraoperative bleeding and operation time ( P > 0.05); the hospitalization time in the observation group [(6.72 ± 1.39) d] was shorter than that in the control group [(8.78 ± 1.43) d, P < 0.001]. The incidence of complications in the observation group (31.71%, 13/41) was lower than that in the control group (53.66%, 22/41, P = 0.045). After treatment, KPS scores in the two groups were higher than those before treatment ( P < 0.001); after treatment, KPS score in the observation group was higher than that in the control group ( P < 0.001). After treatment, the serum LAG-3 levels in the two groups were higher than those before treatment, while DKK-1 levels were lower than those before treatment ( P < 0.001); after treatment, the serum LAG-3 level in the observation group was higher than that in the control group, while the DKK-1 level was lower than that in the control group ( P < 0.001). The total effective rate of the observation group (95.12%, 39/41) was higher than that of the control group (80.49%, 33/41, P = 0.043). Conclusion:The clinical efficacy of surgical resection combined with 131I therapy in elderly patients with differentiated thyroid cancer is good, and it can reduce postoperative complications, up-regulate the expression of LAG-3 and down-regulate the expression of DKK-1.