经口腔前庭腔镜甲状腺切除术联合131Ⅰ治疗化型甲状腺癌的近期效果及分析-《中国医学物理学杂志》

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Title:: Recent results and analysis of transoral endoscopic thyroidectomy vestibular approach combined with 131I for differentiated thyroid cancer

文章编号:: 1005-202X（2022）12-1563-06

作者:: 徐伟宏1; 梅锋2; 李强1; 1.南方医科大学珠江医院甲状腺外科，广东广州 510282； 2.中山市东凤人民医院外二科，广东中山 528425

Author(s):: XU Weihong1; MEI Feng2; LI Qiang1; 1. Department of Thyroid Surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510282, China 2. the Second Department of Surgery, Zhongshan Dongfeng Peoples Hospital, Zhongshan 528425, China

关键词:: 分化型甲状腺癌; 经口腔前庭腔镜甲状腺切除术; 放射性碘131

Keywords:: Keywords: differentiated thyroid cancer Transoral endoscopic thyroidectomy vestibular approach Radioactive iodine 131

分类号:: R736.1；R817.8

DOI:: DOI:10.3969/j.issn.1005-202X.2022.12.017

文献标志码:: A

摘要:: 目的：分析经口腔前庭腔镜甲状腺切除术（TOETVA）联合放射性碘131（131Ⅰ）治疗分化型甲状腺癌（DTC）的效果。方法：回顾性分析2018年7月至2020年5月南方医科大学珠江医院和中山市东凤人民医院收治的80例DTC患者临床资料，按照治疗方案不同分为对照组（46例，实施TOETVA术联合优甲乐治疗）和研究组（34例，接受TOETVA术联合131Ⅰ治疗）。对比两组疗效、甲状腺指标、血清白细胞分化抗原44变异型6（CD44V6）、可溶性白细胞介素-2受体（sIL-2R）水平与细胞凋亡信号受体（Fas）、细胞周期素E蛋白表达、唾液腺功能、近期进展情况。结果：研究组治疗总有效率（82.35%）比对照组（58.70%）高（P<0.05）；研究组治疗后甲状腺球蛋白抗体、促甲状腺激素、甲状腺球蛋白水平均比对照组低（P<0.05）；研究组治疗后血清CD44V6、sIL-2R水平与细胞周期素E蛋白均比对照组低，血清Fas蛋白表达比对照组高（P<0.05）；研究组治疗前后右侧颌下腺、左侧颌下腺、右侧腮腺、左侧腮腺的排泌分数与对照组相比，差异无统计学意义（P>0.05）；研究组随访2年内无病生存率（91.18%）比对照组（71.74%）高（P<0.05）；研究组随访2年内复发率（2.94%）、转移率（8.82%）与对照组（13.04%、21.74%）相比，差异无统计学意义（P>0.05）。结论：TOETVA术联合131Ⅰ治疗有助于提高DTC临床效果，改善患者甲状腺指标，抑制恶性细胞增殖转移，提升近期局部控制率，且对患者唾液腺功能无明显影响。

Abstract:: Abstract: Objective To investigate the feasibility, safety and efficacy of Transoral Endoscopic Thyroidectomy Vestibular Approach (TOETVA) in the treatment of differentiated thyroid cancer (DTC). Methods The clinical data of 80 patients with DTC who were admitted to Zhujiang Hospital, Southern Medical University and Zhongshan Dongfeng Peoples Hospital from July 2018 to May 2019 were retrospectively analyzed. According to the treatment protocol, they were divided into the control group (46 cases, receiving TOETVA combined with 131Ⅰ treatment) and the study group (34 cases, receiving TOETVA combined with levothyroxine tablets treatment). The therapeutic effects, thyroid index, serum cluster of differentiation 44 variant 6(CD44V6), soluble interleukin -2 receptor (sIL-2R) levels, expression of cell apoptosis signal receptor (Fas) and cycline (cycline) proteins, salivary gland function and short-term and medium-term prognosis of the two groups were compared. Results The total effective rate of treatment in the research group was 82.35%, which was higher than that in the control group (58.70%) (P<0.05). The levels of thyroglobulin antibody (TgAb), thyroid-stimulating hormone (TSH), and thyroglobulin (Tg) were all lower than those of the control group (P<0.05). After treatment, the levels of serum CD44V6, sIL-2R and Cycline protein in the treatment group were lower than those of the control group, and the expression level of serum Fas protein in the treatment group was higher than that of the control group (P<0.05). The SRs of the right submandibular gland, left submandibular gland, right parotid gland and left parotid gland before and after treatment in the research group were not significantly different from those in the control group (P>0.05). The disease-free survival rate (91.18%) in the research group within two years of follow-up was higher than that in the control group (71.74%) (P<0.05). The recurrence rate (2.94%) and metastasis rate (8.82%) in the study group within two years of follow-up were not significantly different from those in the control group (13.04% and 21.74%) (P>0.05).Conclusion TOETVA combined with 131Ⅰ therapy can help to improve the clinical effect of DTC, improve the thyroid indexes of patients, inhibit the proliferation and metastasis of malignant cells, and increase recent local control rates. There is no significant effect on the salivary gland function of patients.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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