促甲状腺激素抑制治疗对分化型甲状腺癌术后的疗效及安全性
|
摘要
目的探讨促甲状腺激素抑制治疗对分化型甲状腺癌术后的效果及安全性。方法将70例分化型甲状腺癌患者随机分组,对照组患者给予甲状腺激素代替治疗,实验组患者应用促甲状腺激素抑制治疗,观察比较两组患者复发率、转移率和不良反应发生率差异。结果实验组术后1年、术后3年复发率均明显低于对照组(P <0. 05);实验组术后1年、术后3年颈部淋巴结转移率、远处转移率较对照组明显下降(P <0. 05);实验组不良反应发生率与对照组比较显著下降(P <0. 05)。结论针对分化型甲状腺癌患者术后应用促甲状腺激素抑制治疗可降低复发率及转移率,安全性高,疗效显著,值得推广应用。
Objective To investigate the efficacy and safety of thyrotropin inhibition therapy in differentiated thyroid cancer patients after operation. Methods 70 cases of differentiated thyroid cancer treated in our hospital were randomly divided into two groups. Patients in the control group were treated with thyroid hormone instead of treatment. The experimental group was treated with thyrotropin inhibitory therapy,and the recurrence rate,metastasis rate and adverse reaction rate were compared between the two groups. Results The recurrence rate in the experimental group 1 years and 3 years after operation was significantly lower than that in the control group( P < 0. 05). The cervical lymph node metastasis rate and distant metastasis rate in the experimental group were significantly lower than those in the control group at 3 years and 5 years after operation( P < 0. 05). The incidence of adverse reactions in the experimental group was significantly lower than that in the control group( P < 0. 05). Conclusion Thyrotropin inhibitory therapy can reduce the recurrence rate and metastasis rate in patients with differentiated thyroid carcinoma after operation. It is safe and effective. It is worthy of popularization and application.
Objective To investigate the efficacy and safety of thyrotropin inhibition therapy in differentiated thyroid cancer patients after operation. Methods 70 cases of differentiated thyroid cancer treated in our hospital were randomly divided into two groups. Patients in the control group were treated with thyroid hormone instead of treatment. The experimental group was treated with thyrotropin inhibitory therapy,and the recurrence rate,metastasis rate and adverse reaction rate were compared between the two groups. Results The recurrence rate in the experimental group 1 years and 3 years after operation was significantly lower than that in the control group( P < 0. 05). The cervical lymph node metastasis rate and distant metastasis rate in the experimental group were significantly lower than those in the control group at 3 years and 5 years after operation( P < 0. 05). The incidence of adverse reactions in the experimental group was significantly lower than that in the control group( P < 0. 05). Conclusion Thyrotropin inhibitory therapy can reduce the recurrence rate and metastasis rate in patients with differentiated thyroid carcinoma after operation. It is safe and effective. It is worthy of popularization and application.
引文
[1]IN DT,YU K,LU RQ,et al.Clinicopathological significance of TERT promoter mutation in papillary thyroid carcinomas:A systematic review and meta-ana lysis[J].Clin Endocrinol,2016,85(2):299-305.
[2]唐丽芬,邵小南.131I联合促甲状腺激素抑制治疗对分化型甲状腺癌血生化及骨密度的影响[J].中国现代医学杂志,2016,26(2):68-71.
[3]Cheng zhao,Wenbin jiang,Yuxiu gao,et al.Risk factors for lymph node metastasis(lnm)in patients with papillary thyroid microcarcinoma(ptmc):role of preoperative ultrasound[J].J Int Med Res,2017,45(3):1221-1230.
[4]曹斐,张惠,朱凡,等.131I联合TSH抑制治疗对术后分化型甲状腺癌患者骨生化及骨密度的影响[J].江苏医药,2016,42(3):312-314.
[5]Dao-zhe lin,Ning Qu,Rong-liang shi,et al.Risk prediction and clinical model building for lymph node metastasis in papillary thyroid microcarcinoma[J].Onco Targets Ther,2016,9(2):5307-5316.
[6]张力丹,席永昌,尤立强,等.TSH抑制疗法对分化型甲状腺癌患者术后血清Tg、VEGF、TSGF、CD44V6、s IL-2R及T淋巴细胞亚群水平的影响[J].海南医学院学报,2018,24(2):242-245.
[7]马超.分化型甲状腺癌术后TSH抑制治疗对腰椎、髋关节及膝关节骨密度的影响[J].医学临床研究,2017,34(9):1771-1773.
[8]Haugen BR,Alexander EK,Bible KC,et al.2015 American Thyroid Association(ATA)management guidelinesforadult patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1-133.
[9]Sohn SY,Park WY,Shin HT,et al.Highly concordant key genetic alterations in primary tumors and matched distant metastases in differentiated thyroid cancer[J].Thyroid,2016,26(5):672-682.
[10]唐润薇.抑制剂量的甲状腺激素对40例分化型甲状腺癌患者骨生化和骨密度的影响[J].药物评价研究,2016,39(5):814-817.
[11]Bin Sun,Congli Hu,Zhibin Yang,et al.Midkine promotes hepatocellular carcinoma metastasis by elevating anoikis resistance of circulating tumor cells[J].Oncotarget,2017,8(20):32523-32535.
[12]任崧,马轶明.分化型甲状腺癌全切除术后应用甲状腺激素联合131I治疗疗效及对患者血清甲状腺球蛋白的影响[J].临床医药实践,2016,25(3):171-173.
[13]Nixon IJ,Wang LY,Migliacci JC,et al.An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer[J].Thyroid Official Journal of the American Thyroid Association,2016,26(3):373-380.
[14]刘学,韦智晓,李俊红,等.99 Tcm O4-甲状腺显像联合Tg/TSH对分化型甲状腺癌术后残甲的评估价值[J].山东医药,2017,57(5):67-69.
[2]唐丽芬,邵小南.131I联合促甲状腺激素抑制治疗对分化型甲状腺癌血生化及骨密度的影响[J].中国现代医学杂志,2016,26(2):68-71.
[3]Cheng zhao,Wenbin jiang,Yuxiu gao,et al.Risk factors for lymph node metastasis(lnm)in patients with papillary thyroid microcarcinoma(ptmc):role of preoperative ultrasound[J].J Int Med Res,2017,45(3):1221-1230.
[4]曹斐,张惠,朱凡,等.131I联合TSH抑制治疗对术后分化型甲状腺癌患者骨生化及骨密度的影响[J].江苏医药,2016,42(3):312-314.
[5]Dao-zhe lin,Ning Qu,Rong-liang shi,et al.Risk prediction and clinical model building for lymph node metastasis in papillary thyroid microcarcinoma[J].Onco Targets Ther,2016,9(2):5307-5316.
[6]张力丹,席永昌,尤立强,等.TSH抑制疗法对分化型甲状腺癌患者术后血清Tg、VEGF、TSGF、CD44V6、s IL-2R及T淋巴细胞亚群水平的影响[J].海南医学院学报,2018,24(2):242-245.
[7]马超.分化型甲状腺癌术后TSH抑制治疗对腰椎、髋关节及膝关节骨密度的影响[J].医学临床研究,2017,34(9):1771-1773.
[8]Haugen BR,Alexander EK,Bible KC,et al.2015 American Thyroid Association(ATA)management guidelinesforadult patients with thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1-133.
[9]Sohn SY,Park WY,Shin HT,et al.Highly concordant key genetic alterations in primary tumors and matched distant metastases in differentiated thyroid cancer[J].Thyroid,2016,26(5):672-682.
[10]唐润薇.抑制剂量的甲状腺激素对40例分化型甲状腺癌患者骨生化和骨密度的影响[J].药物评价研究,2016,39(5):814-817.
[11]Bin Sun,Congli Hu,Zhibin Yang,et al.Midkine promotes hepatocellular carcinoma metastasis by elevating anoikis resistance of circulating tumor cells[J].Oncotarget,2017,8(20):32523-32535.
[12]任崧,马轶明.分化型甲状腺癌全切除术后应用甲状腺激素联合131I治疗疗效及对患者血清甲状腺球蛋白的影响[J].临床医药实践,2016,25(3):171-173.
[13]Nixon IJ,Wang LY,Migliacci JC,et al.An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer[J].Thyroid Official Journal of the American Thyroid Association,2016,26(3):373-380.
[14]刘学,韦智晓,李俊红,等.99 Tcm O4-甲状腺显像联合Tg/TSH对分化型甲状腺癌术后残甲的评估价值[J].山东医药,2017,57(5):67-69.