CAJ | 학술논문

目的：探讨分化型甲状腺癌（DTC）术后淋巴结转移临床使用131 I 治疗的方式与效果。方法采用随机抽样法选取术后淋巴结转移的 DTC 患者185例，均予以规范131 I 治疗，评价131 I 治疗的 B 超、CT、Tg变化、131 I 显像特点，判定临床疗效。结果影像学变化：全组患者中，治疗有效153例（82．7％）。153例治疗有效的患者，105例经检查 LMDTC 完全消除（56．8％），48例检查发现缩小（25．9％）。单纯淋巴结转移者治疗后影像学检查结果优于合并脏器转移的患者（χ2＝2．57，P ＝0．02）；淋巴结较小的患者治疗后影像学检查结果优于淋巴结直径相对大的患者（P ＞0．05）。Tg 水平变化：185例患者 Tg 显著下降97例（51．1％），54例患者一般下降（29．2％）；单纯淋巴转移者治疗后 Tg 改善效果优于合并其他脏器转移患者（χ2＝3．41，P ＝0．01）；淋巴结直径较小患者治疗后 Tg 改善效果优于合并其他脏器转移患者（χ2＝6．34，P ＝0．02）。结论131 I 治疗 DTC 患者术后淋巴结转移综合疗效显著，值得在 DTC 临床中运用推广。
목적：탐토분화형갑상선암（DTC）술후림파결전이림상사용131 I 치료적방식여효과。방법채용수궤추양법선취술후림파결전이적 DTC 환자185례，균여이규범131 I 치료，평개131 I 치료적 B 초、CT、Tg변화、131 I 현상특점，판정림상료효。결과영상학변화：전조환자중，치료유효153례（82．7％）。153례치료유효적환자，105례경검사 LMDTC 완전소제（56．8％），48례검사발현축소（25．9％）。단순림파결전이자치료후영상학검사결과우우합병장기전이적환자（χ2＝2．57，P ＝0．02）；림파결교소적환자치료후영상학검사결과우우림파결직경상대대적환자（P ＞0．05）。Tg 수평변화：185례환자 Tg 현저하강97례（51．1％），54례환자일반하강（29．2％）；단순림파전이자치료후 Tg 개선효과우우합병기타장기전이환자（χ2＝3．41，P ＝0．01）；림파결직경교소환자치료후 Tg 개선효과우우합병기타장기전이환자（χ2＝6．34，P ＝0．02）。결론131 I 치료 DTC 환자술후림파결전이종합료효현저，치득재 DTC 림상중운용추엄。
Objective To discuss differentiated thyroid carcinoma (DTC)postoperative lymph node metas-tasis and clinical use and the effect of 131 I treatment.Methods to185 patients with lymph node metastasis of DTC were selected by random sampling method.The standard 131 I treatment was administrated,ultrasound,CT and Tg chan-ges and imaging characteristics of 131 I treatment were evaluated the clinical curative effect was determined.Results Imaging changes:the whole group of patients,153 patients (82.7%)were effective.153 patients with effective treat-ment,105 cases examined LMDTC completely eliminate (56.8%),48 cases examination revealed narrowing (25.9%).Mere lymph node metastasis after treatment was better than that of patients with viscera metastasis,imaging examination results were statistically significant differences (χ2 =2.57,P =0.02).After treatment,imaging examina-tion result in patients with smaller lymph node was superior to that in the patients with relatively large diameter lymph nodes (P >0.05).Tg level changes:there was a significant reduction in the Tg 97 cases of 185 patients (51.1%), and general decline in 54 patients (29.2%).Tg improvement effect of patients with mere lymphatic metastasis after treatment was better than other viscera metastasis in patients with statistically significant differences (χ2 =3.41,P =0.01).Lymph node Tg improved after treatment in patients with small diameter,which was better than that with other viscera metastasis patients with statistically significant differences(χ2 =6.34,P =0.02).Conclusion Comprehensive curative effect of 131 I treatment of lymph node metastasis postoperatively in patients with DTC is distinct,and is worth popularizing in clinical use of DTC.