Impact of extrathyroidal autoimmune diseases on clinical features and the efficacy of Iodine-131 therapy in patients with differentiated thyroid cancer

IF 3.1 4区医学 Q3 IMMUNOLOGY

Immunity, Inflammation and Disease Pub Date : 2024-09-25 DOI:10.1002/iid3.70018

Ya-hong Long, Na Li, Le Ma, Wan-chun Zhang

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引用次数: 0

Abstract

Objective

The aim of this study is to assess the impact of extrathyroidal autoimmune diseases (ADs) on the clinical characteristics and efficacy of iodine-131 (¹³¹I) therapy in patients with differentiated thyroid cancer (DTC).

Methods

Patients with DTC who were received ¹³¹I therapy simultaneously were classified into the combination group (n = 35) and noncombination group (n = 146) depending on the presence of ADs. The clinical characteristics, such as gender, age, tumor lesions, lymph node metastasis, distant metastasis, ¹³¹I therapy efficacy, and use of levothyroxine, were compared between the two groups. Statistical analysis was conducted using SPSS 26.0 and R 4.0.3.

Results

There was a statistically significant difference in age between the combination and noncombination groups (t = −2.872, p < .01), and the optimal cutoff value was 50.5 years. Propensity score matching was completed effectively on a total of 121 patients, using age as the matching factor, comprising 32 cases in the combination group and 80 cases in the noncombination group. The baseline demographic features of the two groups were equivalent after matching (p > .05), and there was no significant difference in the therapeutic efficacy of ¹³¹I between the two groups (p > .05). In the subgroup analysis involving patients aged great than 50.5 years, the levothyroxine/weight (µg/kg) was increased in the combination group, and the difference was statistically significant (p < .05).

Conclusion

While extrathyroidal ADs may enhance the detection of DTC among elderly women, they have no impact on the clinical characteristics of thyroid cancer or the efficacy of ¹³¹I therapy. ADs may necessitate higher per-unit dosages of levothyroxine in patients with DTC, regardless of the clinical status. Consequently, it is not essential for nuclear medicine physicians to consider the presence of ADs when designing treatment plans for patients with DTC.

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甲状腺外自身免疫性疾病对分化型甲状腺癌患者临床特征和碘-131疗法疗效的影响

目的本研究旨在评估甲状腺外自身免疫性疾病（AD）对分化型甲状腺癌（DTC）患者的临床特征和碘-131（131I）疗法疗效的影响。方法将同时接受 131I 治疗的 DTC 患者根据是否存在 ADs 分成联合组（35 人）和非联合组（146 人）。比较两组患者的临床特征，如性别、年龄、肿瘤病变、淋巴结转移、远处转移、131I疗效和左甲状腺素的使用情况。统计分析采用 SPSS 26.0 和 R 4.0.3。结果联合组和非联合组之间的年龄差异有统计学意义（t = -2.872，p < .01），最佳临界值为 50.5 岁。以年龄为匹配因子，共对 121 例患者进行了倾向得分匹配，其中联合组 32 例，非联合组 80 例。配对后，两组患者的基线人口学特征相当（p >.05），两组患者的 131I 疗效也无明显差异（p >.05）。在涉及年龄大于 50.5 岁患者的亚组分析中，联合用药组的左甲状腺素/体重（µg/kg）有所增加，差异有统计学意义（p <.05）。结论虽然甲状腺外AD可提高老年妇女DTC的检出率，但对甲状腺癌的临床特征或131I治疗的疗效没有影响。无论DTC患者的临床状况如何，甲状腺外AD可能都需要增加左甲状腺素的单位剂量。因此，核医学医生在为 DTC 患者设计治疗方案时，并不一定要考虑 AD 的存在。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Immunity, Inflammation and Disease Medicine-Immunology and Allergy

CiteScore

3.60

自引率

0.00%

发文量

146

审稿时长

8 weeks

期刊介绍： Immunity, Inflammation and Disease is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research across the broad field of immunology. Immunity, Inflammation and Disease gives rapid consideration to papers in all areas of clinical and basic research. The journal is indexed in Medline and the Science Citation Index Expanded (part of Web of Science), among others. It welcomes original work that enhances the understanding of immunology in areas including: • cellular and molecular immunology • clinical immunology • allergy • immunochemistry • immunogenetics • immune signalling • immune development • imaging • mathematical modelling • autoimmunity • transplantation immunology • cancer immunology