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Risk stratification for radioactive iodine refractoriness using molecular alterations in distant metastatic differentiated thyroid cancer

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Chinese Journal of Cancer Research 2024年第1期36卷 25-35页

作者： zhuanzhuan mu Xin Zhang Dongquan Liang Jugao Fang Ge Chen Wenting Guo Di Sun Yuqing Sun Zhentian Kai Lisha Huang Jun Liang Yansong Lin Department of Nuclear Medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College(PUMC)HospitalChinese Academy of Medical Sciences&PUMCBeijing 100730China Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine Beijing 100730China Pepperdine University Graduate School of Education and Psychology Los Angeles 90045USA Department of Head and Neck Surgery Affiliated Beijing Tongren HospitalCapital Medical UniversityBeijing 100730China Department of General Surgery State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College(PUMC)HospitalChinese Academy of Medical Sciences&PUMCBeijing 100730China Central Laboratory State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College(PUMC)HospitalChinese Academy of Medical Sciences&PUMCBeijing 100730China Department of Bioinformatics Zhejiang Shaoxing Topgen Biomedical Technology Co.LtdShanghai 201321China Department of Medicine Zhejiang Shaoxing Topgen Biomedical Technology Co.LtdShanghai 201321China Department of Oncology Peking University International HospitalBeijing 102206China

Objective: Patients with radioactive iodine-refractory differentiated thyroid cancer(RAIR-DTC) are often diagnosed with delay and constrained to limited treatment options. The correlation between RAI refractoriness and the underlying genetic characteristics has not been extensively ***: Adult patients with distant metastatic DTC were enrolled and assigned to undergo next-generation sequencing of a customized 26-gene panel(Thyro Lead). Patients were classified into RAIR-DTC or non-RAIR groups to determine the differences in clinicopathological and molecular characteristics. Molecular risk stratification(MRS) was constructed based on the association between molecular alterations identified and RAI refractoriness, and the results were classified as high, intermediate or low ***: A total of 220 patients with distant metastases were included, 63.2% of whom were identified as RAIRDTC. Genetic alterations were identified in 90% of all the patients, with BRAF(59.7% vs. 17.3%), TERT promoter(43.9% vs. 7.4%), and TP53 mutations(11.5% vs. 3.7%) being more prevalent in the RAIR-DTC group than in the non-RAIR group, except for RET fusions(15.8% vs. 39.5%), which had the opposite pattern. BRAF and TERT promoter are independent predictors of RAIR-DTC, accounting for 67.6% of patients with RAIR-DTC. MRS was strongly associated with RAI refractoriness(Pmutations being the predominant contributors, followed by TP53 and DICER1 mutations. MRS might serve as a valuable tool for both prognosticating clinical outcomes and directing precision-based therapeutic interventions.

关键词： Differentiated thyroid cancer distant metastases genetic alterations RAI refractoriness molecular risk stratification

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Distinctive role of DICER1 mutations in distant metastatic thyroid cancer

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Chinese Journal of Cancer Research 2024年第6期36卷 700-712页

作者： Cong Shi zhuanzhuan mu Wenting Guo Xin Zhang Di Sun Yuqing Sun Hao Wang Dingding Zhang Jun Liang Yansong Lin Department of Nuclear Medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine Beijing 100730China Biomedical Engineering Facility of National Infrastructures for Translational Medicine Institute of Clinical MedicinePeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Oncology Qingdao Municipal HospitalSchool of MedicineQingdao UniversityQingdao 266011China Center for Prevention and Early Intervention National Infrastructures for Translational MedicineInstitute of Clinical MedicinePeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing 100730China Key Laboratory of Carcinogenesis&Translational Research(Ministry of Education/Beijing) Department of Medical OncologyPeking University Cancer Hospital&InstituteBeijing 100142China Department of Oncology Peking University International HospitalBeijing 102206China

Objective:This study investigated the clinical significance of DICER1 mutations in patients with distant metastatic follicular cell-derived thyroid cancer(FDTC).Methods:This study included 310 Chinese patients with distant metastatic *** analyzed the interactions between DICER1 mutations and other gene alterations and compared the clinicopathological characteristics of patients with pathogenic(P)or likely pathogenic(LP)DICER1 mutations(n=9),other gene alterations(n=253),and no gene alterations(n=37).To compare FDTCs with different drivers,isolated BRAFV600E,RAS mutations,and RET fusions were compared with isolated DICER1 ***:The prevalence of DICER1 mutations was 6.5%(20/310)in the patient *** patients with DICER1 mutations,45%(9/20)harbored P or LP DICER1 variants and 55%(11/20)harbored DICER1 variants of uncertain significance(VUS).The coexistence of DICER1 mutations and other gene alterations was detected in65%(13/20)of *** with VUS,P or LP DICER1 variants were almost mutually exclusive with early driver alterations(such as BRAFV600E)(11.1%vs.81.8%,P=0.002)and more coexisted with late-hit events,particularly TP53 mutations(44.4%vs.27.3%,P=0.642).Clinically,compared with the no alteration and other alteration groups,the DICER1 mutation group exhibited larger primary tumors,higher poorly differentiated thyroid cancer proportion,more extrathyroidal extension,more extrapulmonary metastases,and higher radioactive iodine-refractory proportion(all Pmutations differed from those with isolated BRAFV600E and RET fusions in terms of tumor size,poorly differentiated thyroid cancer proportion,and metastatic sites,but were similar to cases with isolated RAS mutations in the high proportion of follicular thyroid cancer,N0,and extrapulmonary ***:mutation of DICER1 gene is a non-negligible molecular event and it may represent an aggressive subset of ***1 has RAS-like clinical cha

关键词： DICER1 mutations follicular cell-derived thyroid cancer distant metastatic next-generation sequencing clinical aggressiveness

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经验性^(131)I治疗对甲状腺乳头状癌不摄碘肺转移患者价值存疑

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中国癌症杂志 2020年第12期30卷 991-995页

作者：慕转转李征张鑫林岩松中国医学科学院、北京协和医学院北京协和医院核医学科北京100730 核医学分子靶向诊疗北京市重点实验室北京100730

背景与目的:甲状腺乳头状癌(papillary thyroid cancer,PTC)肺转移但^(131)I全身显像(whole body scan,WBS)阴性的患者是否可从经验性^(131)I治疗中获益仍存在争议。探究经验性^(131)I治疗对PTC伴不摄碘性肺转移患者的必要性。方法:经... 详细信息

背景与目的:甲状腺乳头状癌(papillary thyroid cancer,PTC)肺转移但^(131)I全身显像(whole body scan,WBS)阴性的患者是否可从经验性^(131)I治疗中获益仍存在争议。探究经验性^(131)I治疗对PTC伴不摄碘性肺转移患者的必要性。方法:经筛选纳入回顾性分析2008年—2019年就诊于北京协和医院核医学科的45例PTC仅伴肺转移患者,比较清甲成功后再行清灶治疗后全身显像(post-treated whole body scan,RxWBS)提示肺转移灶未摄碘的“经验性^(131)I治疗”前后的血清甲状腺球蛋白(thyroglobulin,Tg)水平变化,以及同一例患者在经验性^(131)I治疗和仅促甲状腺激素(thyroid-stimulating hormone,TSH)抑制治疗两阶段血清Tg变化速度及影像学改变。据影像学改变,观察这部分患者在仅TSH抑制治疗时的无进展生存期(progression-free survival,PFS)。结果:45例PTC患者在经验性^(131)I治疗后血清Tg水平较治疗前升高(P=0.001)。经验性^(131)I治疗和仅TSH抑制治疗两阶段患者的血清Tg变化速度(P=0.123)及影像学改变(P=1.000)差异均无统计学意义。仅TSH抑制治疗时患者的中位PFS可达到54.4(46.5,66.2)个月。结论:经验性^(131)I治疗对于PTC伴不摄碘性肺转移患者的疗效甚微,并可能适得其反,宜及时终止经验性^(131)I治疗。

关键词：甲状腺乳头状癌肺转移 ^(131)I治疗摄碘性

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Predictability Study of Weather and Climate Events Related to Artificial Intelligence Models

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Advances in Atmospheric Sciences 2025年第1期42卷 1-8页

作者： mu mu Bo QIN Guokun DAI Department of Atmospheric and Oceanic Sciences&Institute of Atmospheric Sciences Fudan UniversityShanghai 200438China Shanghai Key Laboratory of Ocean-land-atmosphere Boundary Dynamics and Climate Change Fudan UniversityShanghai 200438China Shanghai Frontiers Science Center of Atmosphere-Ocean Interaction Fudan UniversityShanghai 200438China CMA-FDU Joint Laboratory of Marine Meteorology Shanghai 200438China Key Laboratory of Polar Atmosphere-ocean-ice System for Weather and Climate Ministry of EducationShanghai 200438China

Conducting predictability studies is essential for tracing the source of forecast errors,which not only leads to the improvement of observation and forecasting systems,but also enhances the understanding of weather and climate *** the past few decades,dynamical numerical models have been the primary tools for predictability studies,achieving significant ***,with the advances in artificial intelligence(AI)techniques and accumulations of vast meteorological data,modeling weather and climate events using modern data-driven approaches is becoming trendy,where FourCastNet,Pangu-Weather,and GraphCast are successful *** this perspective article,we suggest AI models should not be limited to forecasting but be expanded to predictability studies,leveraging AI's advantages of high efficiency and self-contained optimization *** this end,we first remark that AI models should possess high simulation capability with fine spatiotemporal resolution for two kinds of predictability *** models with high simulation capabilities comparable to numerical models can be considered to provide solutions to partial differential equations in a data-driven ***,we highlight several specific predictability issues with well-determined nonlinear optimization formulizations,which can be well-studied using AI models,holding significant scientific *** addition,we advocate for the incorporation of AI models into the synergistic cycle of the cognition–observation–model *** predictability studies have the potential to transform“big data”to“big and better data”and shift the focus from“AI for forecasts”to“AI for science”,ultimately advancing the development of the atmospheric and oceanic sciences.

关键词： predictability artificial intelligence models simulation and forecasting nonlinear optimization cognition–observation–model paradigm

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阿帕替尼治疗局部晚期/进展性碘难治性分化型甲状腺癌的血清学反应评估

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中华核医学与分子影像杂志 2022年第11期42卷 644-649页

作者：孙郁青慕转转魏星张鑫王湘林岩松中国医学科学院、北京协和医学院北京协和医院核医学科、核医学分子靶向诊疗北京市重点实验室、疑难重症及罕见病国家重点实验室(北京协和医院) 北京100730 北京大学国际医院肿瘤内科北京102200 中国医学科学院、北京协和医学院北京协和医院肿瘤内科北京100730

目的分析碘难治性分化型甲状腺癌(RAIR-DTC)患者阿帕替尼治疗过程中的血清学疗效反应与传统结构影像学疗效评价的疾病进展趋势及预后的关系。方法回顾性分析2016年3月至2022年6月就诊于北京协和医院行阿帕替尼治疗局部进展和(或)转移性R... 详细信息

目的分析碘难治性分化型甲状腺癌(RAIR-DTC)患者阿帕替尼治疗过程中的血清学疗效反应与传统结构影像学疗效评价的疾病进展趋势及预后的关系。方法回顾性分析2016年3月至2022年6月就诊于北京协和医院行阿帕替尼治疗局部进展和(或)转移性RAIR-DTC的Ⅱ期临床试验患者19例,其中男9例、女10例,年龄46.0(41.0,57.5)岁。探讨血清甲状腺球蛋白(Tg)变化与实体瘤疗效评价标准1.1(RECIST 1.1)结构影像学疗效评估及疾病进展趋势的关系;探讨剂量调整后Tg变化和结构影像学上靶病灶最大径变化的关系。采用Mann-WhitneyU检验、Wilcoxon符号秩检验分析数据。结果(1)中位随访49.41个月,19例患者基线期Tg为363.20(13.08,2490.50)μg/L,血清Tg治疗响应时间为0.47(0.47,0.98)个月,依据RECIST 1.1标准的靶病灶治疗响应时间为1.80(1.30,1.90)个月。初始治疗2周、4周、8周后,全队列中位Tg分别下降38.68%、64.70%和78.94%,8周后中位靶病灶最大径缩小幅度为33.48%。根据患者最佳疗效反应,将其分为部分缓解(PR)组(15例)和疾病稳定(SD)组(4例),PR组与SD组患者中位Tg下降幅度分别为87.00%与28.79%,相应组别中位靶病灶最大径缩小幅度分别为45.00%与21.22%。据末次疗效评估,将患者分为疾病进展(PD)组(13例)和非PD(包括PR和SD)组(5例),PD组患者中位Tg升高幅度大于非PD组(381.55%与175.43%;U=10.00,P=0.037)。第1次剂量调整后,Tg升高幅度与对应靶病灶最大径增大幅度分别为167.31%与2.14%,第2次剂量调整后两者分别为231.06%与9.73%。第1次剂量调整前后Tg变化及对应靶病灶最大径变化的差异均有统计学意义(z值:-3.06和-2.23,P值:0.002和0.026)。结论在阿帕替尼治疗RAIR-DTC中,相较于传统影像学(RECIST 1.1),Tg可更灵敏地反映阿帕替尼疗效及疾病进展趋势。

关键词：甲状腺肿瘤分子靶向治疗药物疗法甲状腺球蛋白实体肿瘤疗效评价标准预后

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^(131)I辅助治疗对BRAF^(V600E)突变型非远处转移性甲状腺乳头状癌患者疗效的初步探讨

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中华核医学与分子影像杂志 2021年第4期41卷 212-217页

作者：宋娟娟慕转转鲁涛张鑫林岩松中国医学科学院、北京协和医学院北京协和医院核医学科、核医学分子靶向诊疗北京市重点实验室 100730 中国医学科学院、北京协和医学院北京协和医院病理科 100730

目的探讨^(131)I辅助治疗对B-Raf原癌基因丝/苏氨酸蛋白激酶(BRAF)^(V600E)突变型非远处转移性甲状腺乳头状癌(PTC)患者的长期治疗疗效反应。方法回顾性分析2008年1月至2019年1月间就诊于北京协和医院仅行1次^(131)I治疗且临床、随访(... 详细信息

目的探讨^(131)I辅助治疗对B-Raf原癌基因丝/苏氨酸蛋白激酶(BRAF)^(V600E)突变型非远处转移性甲状腺乳头状癌(PTC)患者的长期治疗疗效反应。方法回顾性分析2008年1月至2019年1月间就诊于北京协和医院仅行1次^(131)I治疗且临床、随访(中位随访时间63个月)及评估资料完整的181例非远处转移性PTC患者[男65例,女116例,年龄(38.9±11.8)岁]资料。按其原发灶BRAFV600E基因是否突变分为突变型组和野生型组;根据^(131)I治疗剂量的不同,分为清除残留甲状腺组织(简称清甲)治疗组(1.1 GBq)和辅助治疗组(3.7~5.5 GBq)。采用两独立样本t检验、Mann-WhitneyU检验和χ^(2)检验比较各组患者的临床、病理特征及^(131)I治疗后长期治疗疗效反应。结果BRAFV600E突变型患者(n=150)的^(131)I治疗前刺激性甲状腺球蛋白(ps-Tg)水平明显高于野生型[n=31;6.32(0.90,8.70)与3.92(0.40,4.40)μg/L;z=-2.413,P=0.016],但2组的其余临床病理特征(包括年龄、性别、肿瘤大小、多灶性、被膜侵犯、N分期)差异均无统计学意义(t=-0.663,z=-1.151,χ^(2)值:0.003~1.491,均P>0.05),2组的治疗疗效反应差异也无统计学意义(χ^(2)=1.094,P=0.778)。81例接受^(131)I辅助治疗的患者中,突变型组(n=69)的ps-Tg水平高于野生型组[n=12;8.70(1.30,11.80)与3.40(0.30,4.50)μg/L;z=-2.194,P=0.028];但2组的治疗疗效反应差异无统计学意义(χ^(2)=1.792,P=0.617)。BRAFV600E突变型患者中,与清甲治疗组(n=81)相比,辅助治疗组(n=69)肿瘤较大[1.52(0.95,2.00)与1.21(0.60,1.50)cm;z=-2.728,P=0.006]、N分期较晚(χ^(2)=11.460,P=0.003)、ps-Tg水平较高[8.70(1.30,11.80)与4.34(0.50,5.30)μg/L;z=-3.314,P=0.001],但2组的治疗疗效反应差异无统计学意义(χ^(2)=6.478,P=0.091)。结论^(131)I辅助治疗有助于改善肿瘤较大、淋巴结分期较晚、ps-Tg水平较高的BRAFV600E突变型非远处转移性PTC患者的较长期治疗疗效反应。

关键词：甲状腺肿瘤原癌基因蛋白质B-raf 突变放射疗法碘放射性同位素治疗结果

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Emission characteristics and probabilistic health risk of volatile organic compounds from leather sofa

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Journal of Environmental Sciences 2025年第2期148卷 79-87页

作者： Chuanhui mu Yuling Tang Zhaohui Yang Jianfei Zhou Bi Shi National Engineering Laboratory for Clean Technology of Leather Manufacture Sichuan UniversityChengdu 610065China Research Institute of Leather and Footwear Industry of Wenzhou Wenzhou 325088China Key Laboratory of Leather Chemistry and Engineering of Ministry of Education Sichuan UniversityChengdu 610065China

Furniture is identified as a vital volatile organic compound(VOC)emission source in the indoor *** has become the most common raw and auxiliary fabric material for upholstered furniture,particularly with extensive consumption in sofas,due to its abundant resources and efficient *** being widely traded across the world,little research has been conducted on the VOCs released by leathermaterials and their health risk assessment in the indoor ***,this study investigated the VOC emissions of leather with different grades and the health risk of the inhalation *** on the ultra-fast gas phase electronic nose(EN)and GC-FID/Qtof,the substantial emissions of aliphatic aldehyde ketones(Aks),particularly hexanal,appear to be the cause of off-flavor in medium and low grade(MG and LG)sofa *** health risk assessment indicated that leather materials barely pose non-carcinogenic and carcinogenic effects to *** the abundance of VOC sources and the accumulation of health risks in the indoor environment,more stringent specifications concerning qualitative and quantitative content should be extended to provide VOC treatment basic for the manufacturing industry and obtain better indoor air quality.

关键词： Indoor environment Leather Volatile organic compounds(VOCs) Health risk assessment

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Turbulent Agglomeration of Microparticles in a Cylinder Wake Flow Using LES-DEM:Focusing on the Effect of the Reynolds Number

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Journal of Thermal Science 2025年第1期34卷 34-49页

作者： WANG Shuang mu Lin LI Xue XIE Jun DONG Ming School of Energy and Power Engineering Dalian University of TechnologyDalian 116024China School of Optical Information and Energy Engineering Wuhan Institute of TechnologyWuhan 430205China School of Energy and Environment Shenyang Aerospace UniversityShenyang 110136China

Turbulent agglomeration is viewed as a promising technology for enhancing fine particle removal *** better understand particle transport,agglomeration behaviors,and fluid-particle interactions,we numerically explored these phenomena under cylindrical vortex wake influence using a coupled large eddy simulation and discrete element method(LES-DEM)*** validity of the LES approach was verified by comparison with available direct numerical simulation(DNS)*** adopted the Johnson-Kendall-Roberts(JKR)contact model for particle-particle *** particle dispersion and agglomeration characteristics of particles with different diameters(d_(p)=2-20μm)in the laminar and transition of shear layer(TrSL)flow regimes were *** particles were concentrated at the vortex centers,while larger particles accumulated around the *** agglomeration efficiency exhibited an M-shaped profile spanwise(y-direction).With increasing Reynolds number,the agglomeration efficiency and turbulence intensity *** particle agglomeration efficiency peaks at a certain Reynolds ***,at higher Reynolds numbers,reducing the residence time of particles in the flow field decreases the agglomeration efficiency.

关键词： microparticle particle agglomeration discrete element method large eddy simulation

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转移性儿童及青少年分化型甲状腺癌基因与临床特征的关系

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中华医学杂志 2024年第20期104卷 1837-1843页

作者：潘逸缙鞠高达慕转转孙郁青孙迪梁军林岩松中国医学科学院北京协和医学院北京协和医院核医学科疑难重症及罕见病国家重点实验室核医学分子靶向诊疗北京市重点实验室北京100730 北京大学国际医院肿瘤内科北京102200

目的探讨转移性儿童及青少年分化型甲状腺癌(caDTC)基因与临床特征的关系。方法横断面研究,纳入2020年12月至2022年12月就诊于北京协和医院存在淋巴结或远处转移性的caDTC患者,根据纳排标准共入组67例患者。比较不同基因组间临床病理特... 详细信息

目的探讨转移性儿童及青少年分化型甲状腺癌(caDTC)基因与临床特征的关系。方法横断面研究,纳入2020年12月至2022年12月就诊于北京协和医院存在淋巴结或远处转移性的caDTC患者,根据纳排标准共入组67例患者。比较不同基因组间临床病理特征及摄碘差异,并以12岁为界行亚组分析。结果67例caDTC中,确诊年龄[M(Q_(1),Q_(3))]为13.2(9.7,16.9)岁,男23例,女44例。68.7%(46/67)的患者存在远处转移(M1期)。68.7%(46/67)检测出致病性或可能致病性基因突变,RET或NTRK融合(简称RET/NTRK)最多[43.3%(29/67)],BRAF V600E突变次之[19.4%(13/67)],仅1例为NRAS Q61R突变。将患者分为RET/NTRK融合组(n=29)、BRAF突变组(n=12)、其他突变组(n=4)及无突变组(n=21)(1例患者因合并NRAS Q61R突变和BRAF V600E突变未纳入基因突变亚型分组比较)。基因特征分组比较显示,相较于BRAF突变组,RET/NTRK融合组的中位确诊年龄较小[12.6(9.3,15.9)比17.2(15.5,18.1)岁,P<0.001],突变负荷≥2的比例更高(10.4%比8.3%,P=0.027),差异均有统计学意义。46例M1期患者中,71.7%(33/46)初始摄碘,30.4%(14/46)发展为碘难治性(RAIR)。年龄分组比较中,相较≥12岁组,<12岁组男性比例更高(51.9%比22.5%,P=0.013)和BRAF V600E突变发生率更低(0比32.5%,P<0.001)。结论RET/NTRK在转移性caDTC中发生率最高,并呈现低龄化和高远处转移率的特征,尽管转移性病灶多数初始摄碘,但易发生RAIR。应重视RET/NTRK融合在低龄caDTC侵袭性及碘抵抗发生中的潜在作用。

关键词：甲状腺肿瘤分化型甲状腺癌儿童及青少年基因检测放射性碘难治转移性

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血清Tg用于远处转移性分化型甲状腺癌131I治疗的疗效评估

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中华核医学与分子影像杂志 2020年第6期40卷 329-333页

作者：慕转转刘杰蕊鲁涛陈黎波林岩松中国医学科学院、北京协和医学院北京协和医院核医学科、核医学分子靶向诊疗北京市重点实验室 100730 中国医学科学院、北京协和医学院北京协和医院病理科 100730

目的探索血清甲状腺球蛋白(Tg)在决策分化型甲状腺癌远处转移(DM-DTC)131I治疗反应及后续治疗中的意义。方法回顾性分析2008年1月至2019年12月间北京协和医院62例甲状腺乳头状癌(PTC)合并肺转移患者[男20例,女42例,年龄(38.1±15.9)岁]... 详细信息

目的探索血清甲状腺球蛋白(Tg)在决策分化型甲状腺癌远处转移(DM-DTC)131I治疗反应及后续治疗中的意义。方法回顾性分析2008年1月至2019年12月间北京协和医院62例甲状腺乳头状癌(PTC)合并肺转移患者[男20例,女42例,年龄(38.1±15.9)岁]资料,根据131I治疗后全身显像(Rx-WBS)判断转移灶是否摄碘,将其分为不摄碘组和摄碘组。比较2组患者经131I治疗的血清Tg反应(包括Tg变化及Tg变化速度),采用二元logistic回归分析探究血清Tg变化速度与影像学进展的关系。采用受试者工作特征(ROC)曲线分析获得Tg变化速度预测影像学进展的最佳界值。另比较不摄碘组患者再次行131I治疗与仅随诊2种治疗方案下血清Tg反应情况。采用χ2检验和Mann-Whitney U检验分析数据。结果131I治疗后,不摄碘组(n=25)Tg水平上升者达60.0%(15/25),而摄碘组(n=37)仅21.6%(8/37;χ2=9.417,P=0.002);不摄碘组Tg水平总体呈上升趋势,Tg变化速度达0.05(-0.16,0.15)μg·L-1·月-1,而摄碘组总体呈下降趋势,Tg变化速度达-0.18(-1.95,0.01)μg·L-1·月-1(U=265.000,P=0.005)。影像学反应与Tg变化速度有关[比值比(OR)=53.005,P0.05)。结论血清Tg监测有助于灵敏地评估DM-DTC患者中实体瘤疗效评估标准无法准确判断的131I治疗后微小变化,动态Tg监测有助于为不摄碘患者进行131I治疗的必要性提供证据。

关键词：甲状腺肿瘤肿瘤转移放射疗法碘放射性同位素甲状腺球蛋白治疗结果

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