Objective: To investigate the influential factors of efficacy of the first (131)I ablation therapy for thyroid remnant in papillary thyroid microcarcinoma (PTMC) patients after thyroidectomy. Methods: Eighty-nine PTMC patients who underwent twice (131)I ablation therapy and (131)I whole body follow-up scan ((131)I-WBS) within 5 to 8 months in our department from September 2007 to October 2016 were identified and enrolled in present study. Patients were divided into complete-ablation group and uncomplete-ablation group according to whether or not radioactivity was detected at the thyroid bed in (131)I-WBS. The χ(2) test and multi-variance Binary logistic regression were performed for the factors which might affect the therapeutic efficacy. Results: The first (131)I ablation therapy was successful in 41 of 89 patients (46.07%). Residual thyroid weight was found to be associated with therapeutic efficacy (P<0.05), while gender, age, surgical method, lesions'maximum diameter, with or without LN metastasis, with or without distant metastasis, time of operation from first (131)I treatment, lesions'number, thyroid stimulating hormone (TSH), thyroglobulin (Tg), the consistency of (131)I-WBS and (99)Tc(m)-pertechnatate, TNM stage, ATA risk, Tg/TSH ratio were not significant associated with therapeutic efficacy. Binary logistic regression analysis was performed in these respects and it indicated that residual thyroid weight and ATA risk were not statistically significant independent variable (P>0.05). Conclusions: Residual thyroid weight might affect efficacy of the first (131)I ablation therapy on thyroid remnant in PTMC patients after thyroidectomy, but it is not an independent factor. Multiple interrelated factors should be considered when predicting the efficacy of the first (131)I ablation therapy.
目的： 探讨甲状腺微小乳头状癌(PTMC)患者术后首次(131)I清除残留甲状腺组织(简称清甲)疗效的影响因素。 方法： 2007年9月至2016年10月间在山西医科大学第一医院首次行(131)I清甲治疗、5～8个月后行第2次(131)I清甲治疗，并行(131)I全身显像的PTMC患者89例。根据(131)I全身显像是否可见甲状腺组织显影，将患者分为清甲成功组和未成功组。(131)I清甲疗效影响因素分析分别采用卡方检验进行单因素分析和logistic多因素回归分析。 结果： 89例PTMC患者术后首次清甲成功41例，清甲成功率为46.07%。单因素分析显示，残留甲状腺质量与首次(131)I清甲疗效有关(P<0.05)，性别、年龄、手术方式、病灶最大直径、是否有淋巴结转移、是否有远处转移、手术距首次(131)I治疗时间、病灶数量、促甲状腺激素(TSH)、甲状腺球蛋白(Tg)、Tg/TSH、甲状腺平面显像与(131)I全身显像的一致性、TNM分期和复发危险度分层与首次(131)I清甲疗效无关(均P>0.05)。logistic回归分析结果显示，残留甲状腺质量和复发危险度分层均无统计学意义(均P>0.05)。 结论： 残留甲状腺质量是影响PTMC患者术后首次清甲疗效的因素，但非独立因素，应将综合考虑多个相互关联的因素来预测PTMC患者术后首次清甲的疗效。.
Keywords: Influencing factors; Iodine radioisotopes; Papillary thyroid microcarcinoma; Treatment outcome.