Clinical Investigation
Predictive value of cellular immune status before initial 131I treatment for treatment response in young and middle-aged patients with papillary thyroid cancer
Lu Chenghui, Liu Xinfeng, Li Jiao, Wang Guoqiang, Wang Zenghua, Han Na, Zhang Yingying, Wang Xufu, Lin Yansong
Published 2023-02-25
Cite as Chin J Nucl Med Mol Imaging, 2023, 43(2): 102-105. DOI: 10.3760/cma.j.cn321828-20210812-00277
Abstract
ObjectiveTo investigate the value of cellular immune status before initial 131I treatment for predicting treatment response in young and middle-aged patients with papillary thyroid cancer (PTC).
MethodsFrom March 2018 to April 2019, 150 young and middle-aged patients with PTC (46 males, 104 females, age (40.0±9.8) years) who underwent total thyroidectomy and neck lymph node dissection in the Affiliated Hospital of Qingdao University were enrolled retrospectively. All patients underwent radioablation 1-2 months after operation, and the serum lymphocyte subsets (CD3+ , CD4+ , CD8+ , CD4/CD8) as well as natural killer (NK) cells were detected 1 d before the initial 131I treatment. Patients were divided into excellent response (ER) group and non-ER group according to the response of 6-12 months after 131I treatment. Clinicopathological characteristics, preablative stimulated thyroglobulin (psTg), initial 131I dose and lymphocyte subsets that might affect the response to 131I treatment were analyzed (independent-sample t test, Mann-Whitney U test, χ2 test, multiple logistic regression analysis). ROC curve analysis was used to evaluate the predictive value of significant factors for non-ER.
ResultsOf 150 patients, 84 cases were in ER group (56.00%), and 66 cases (44.00%) were in non-ER group. Age (z=-2.86, P=0.004), M stage (χ2=13.64, P<0.001), psTg (z=-8.94, P<0.001), initial 131I dose (z=-7.60, P<0.001), CD4+ (t=2.50, P=0.014), CD4/CD8 (z=-2.22, P=0.027) of the two groups were significantly different. Multivariate analysis showed that psTg (odds ratio (OR)=1.27, 95% CI: 1.16-1.40, P<0.001) and CD4/CD8 (OR=0.39, 95% CI: 0.15-0.99, P=0.048) were independent factors for predicting 131I treatment response. The cut-off values of psTg and CD4/CD8 for predicting non-ER were 6.78 μg/L and 1.67, respectively.
ConclusionsCellular immune status before initial 131I treatment may predict treatment response in young and middle-aged patients with PTC. It indicates non-ER response when Tg is higher than 6.78 μg/L and CD4/CD8 is lower than 1.67.
Key words:
Thyroid neoplasms; Carcinoma, papillary; Radiotherapy; Iodine radioisotopes; Treatment outcome; Forecasting
Contributor Information
Lu Chenghui
Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Liu Xinfeng
Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Li Jiao
Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Wang Guoqiang
Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Wang Zenghua
Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Han Na
Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Zhang Yingying
Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
Wang Xufu
Department of Nuclear Medicine, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
NHC Key Laboratory of Nuclear Medicine, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, Wuxi 214063, China
Lin Yansong
Department of Nuclear Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences
Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear Medicine, Beijing 100730, China
