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Analysis of Curative Effect and Influencing Factors of N1 Stage Papillary Thyroid Micro-Carcinoma and Papillary Thyroid Non-Micro Carcinoma After Initial Radioactive Iodine Ablation Therapy

Authors Yun C, Wu M, Xiao J, Liu Y, Zhang W, Cao J

Received 18 November 2020

Accepted for publication 19 January 2021

Published 12 February 2021 Volume 2021:13 Pages 1427—1434


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Seema Singh

Canhua Yun,1 Meiling Wu,1 Juan Xiao,2 Yong Liu,1 Wei Zhang,1 Jingjia Cao1

1Department of Nuclear Medicine, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, People’s Republic of China; 2Center of Evidence-Based Medicine, Institute of Medical Sciences, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250033, People’s Republic of China

Correspondence: Jingjia Cao No. 247, Beiyuan Street, Jinan City, Shandong Province, People’s Republic of China
Tel +86 17660083825

Objective: To compare the efficacy and influencing factors of initial radioactive iodine (RAI) ablation therapy for postoperative N1 stage papillary thyroid micro-carcinoma (PTMC) and papillary thyroid non-micro carcinoma (PTC), and to explore the necessity of RAI for N1 stage PTMC.
Methods: A retrospective analysis of patients with N1 stage papillary thyroid cancer who underwent RAI in our department from January 2018 to June 2019. According to the tumor diameter, papillary thyroid carcinoma was divided into PTMC group (≤ 1.0cm) with 129 patients and PTC group (> 1.0 cm) with 214 patients. According to the 2015 ATA guidelines, the patient’s treatment response was evaluated 6– 8 months after discharge from the hospital: excellent response (ER), indeterminate response (IDR), biochemical incomplete response (BIR), and structural incomplete response (SIR). IDR, BIR, and SIR were classified into NER group. Chi-squared test, independent sample t-test, Mann–Whitney U test, and binary logistic regression analysis were used to compare the differences between PTMC and PTC patients.
Results: The ps-Tg of the PTMC group was significantly lower than that of the PTC group (P = 0.001), and the ER ratio of the PTMC group was higher (χ2 = 5.445, P < 0.05). The ER ratio of PTMC patients in the N1a group was significantly higher than that of PTC patients (80%, 66.7%, χ2 = 4.076, P < 0.05), while the ER ratio of PTMC in the N1b group was not significantly different from that of PTC. Gender, N stage, and ps-Tg were found to be independent factors of RAI treatment response.
Conclusion: The efficacy of the initial RAI of PTMC patients was significantly better than that of PTC patients. There was no significant difference in the efficacy of RAI between males with PTMC, N1b stage, ps-Tg ≥ 5.87ng/mL and PTC patients, which suggested that RAI is necessary for these patients.

Keywords: papillary thyroid micro-carcinoma, papillary thyroid non-micro carcinoma, curative effect, RAI

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