Long-term effects on parathyroid function and risk factors for permanent hypoparathyroidism in post-surgical differentiated thyroid cancer patients treated with 131I: a retrospective analysis of clinical data

IF 2.3 4区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Clinical and Translational Imaging Pub Date : 2024-05-10 DOI:10.1007/s40336-024-00634-3

Tong Liu, Zhiting Zhang, Yihan Tian, Yanhui Ji, Wei Li

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Abstract

Purpose

This study aims to explore the long-term effects on parathyroid function and risk factors associated with permanent hypoparathyroidism (HPT) in differentiated thyroid cancer (DTC) patients treated with ¹³¹I.

Methods

201 postoperative DTC patients were included. Serum levels of parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OH-VD), calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) were collected before (baseline) and after ¹³¹I treatment. Patients were divided into permanent HPT group and non-permanent HPT group, and risk factors were analyzed using penalized logistic regression (PLR).

Results

There were no statistically significant differences in serum levels of PTH, 25-OH-VD, Ca, P, and ALP among the five time points (baseline, 6 months, 12 months, 24 months, and 36 months) (P > 0.05). Multivariate PLR analysis revealed that the presence of functional metastases in the first ¹³¹I-SPECT/CT-whole-body scan (¹³¹I-WBS) was a significant risk factor for permanent HPT (OR = 21.392, P < 0.05).

Conclusions

Postoperative ¹³¹I therapy for DTC has no significant adverse effects on the parathyroid function within three years, but extremely few patients still develop permanent HPT, with an increased risk in those with functional metastases in the first ¹³¹I-WBS.

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接受131I治疗的分化型甲状腺癌术后患者甲状旁腺功能的长期影响和永久性甲状旁腺功能减退症的风险因素：临床数据的回顾性分析

目的本研究旨在探讨接受131I治疗的分化型甲状腺癌（DTC）患者甲状旁腺功能的长期影响以及与永久性甲状旁腺功能减退症（HPT）相关的风险因素。在131I治疗前（基线）和治疗后收集血清中甲状旁腺激素（PTH）、25-羟维生素D（25-OH-VD）、钙（Ca）、磷（P）和碱性磷酸酶（ALP）的水平。结果五个时间点（基线、6 个月、12 个月、24 个月和 36 个月）的血清 PTH、25-OH-VD、钙、磷和 ALP 水平差异无统计学意义（P > 0.05）。多变量PLR分析显示，首次131I-SPECT/CT全身扫描（131I-WBS）中出现功能性转移灶是永久性HPT的重要风险因素（OR = 21.392，P <0.05）。结论131I治疗DTC术后三年内对甲状旁腺功能无明显不良影响，但仍有极少数患者发展为永久性HPT，首次131I-WBS中出现功能性转移灶的患者风险更高。

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来源期刊

Clinical and Translational Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

3.60

自引率

4.80%

发文量

期刊介绍： Clinical and Translational Imaging is an international journal that publishes timely, up-to-date summaries on clinical practice and translational research and clinical applications of approved and experimental radiopharmaceuticals for diagnostic and therapeutic purposes. Coverage includes such topics as advanced preclinical evidence in the fields of physics, dosimetry, radiation biology and radiopharmacy with relevance to applications in human subjects. The journal benefits a readership of nuclear medicine practitioners and allied professionals involved in molecular imaging and therapy.