分化型甲状腺癌放射碘治疗后血清肿瘤标志物变化的评价

Sorush Niknamian
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From each\npatient, 4 mL of chelated serum for serological studies on tumor markers and 2 mL\nof oxalated serum for spectrophotometry studies on cell death were used in three\nstages. The first stage before the iodine therapy, the second stage, after 48 hours, and\nthe third stage, 30 days after radioiodine therapy were studied and the results were\nevaluated by the one-way repeated measures ANOVA test.\nResults: According to the results of dependent paired T-Test, AFP, in the periods\nbefore, 48 hours and 1 month after radioiodine therapy, respectively were 3.46 ± 1.21\nand 3.74 ± 1.37 and 3.76 ± 1.25 (p <0.0005). About CA 19-9 in the periods before,\n48 hours and one month after radioiodine therapy, the results were 9.30 ± 6.32, 9.95\n± 6.92 (p = 0.040) and 11.26 ± 7.49 (p <0.0005) respectively. About CEA, the results\nwere 1.60 ± 0.60, 1.47 ± 0.55 and 2.23 ± 0.69 (p <0.0005), respectively. In the case\nof tumor marker CA 15-3 results were 15.53 ± 6.48 and 1.60 ± 0.60 and 15.68 ± 6.52\n(p = 0.014), respectively and in the case of ALP, results were 124.22 ± 5 and 122.2 ±\n6 and 116.7 ± 7 (p <0.0005), respectively.\nConclusion: According to the same studies and the acquired results, it can be\nconcluded that the tumor markers CEA and CA19-9 are more acceptable and\nsustainable for monitoring the malignancy and progressive disease in patients with\nthyroid cancer. The decreasing ALP is normal and transient. The increase of AFP and\nCA15-3 is not even statistically reliable. 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引用次数: 1

摘要

简介:放射性碘是治疗甲状腺癌症的有效药物。本研究的目的是评估放射性碘131治疗患者的血清肿瘤标志物。材料和方法:选择45例16~60岁的女性甲状腺癌手术患者,转诊至内马子医院核医学科(术后碘治疗)。该选择是在相互交流的基础上进行的,患者的信息是同意书。本研究仅选择首次转诊且无任何其他疾病的甲状腺癌患者。给选定的患者开了剂量为150 mCi的I-131。每个患者分三个阶段使用4mL螯合血清用于肿瘤标志物的血清学研究,2mL草酸化血清用于细胞死亡的分光光度法研究。对碘治疗前的第一阶段、碘治疗48小时后的第二阶段和碘治疗30天后的第三阶段进行研究,并通过单因素重复测量方差分析检验结果。结果:根据依赖配对T检验结果,放射性碘治疗前、48小时和1个月的AFP分别为3.46±1.21和3.74±1.37和3.76±1.25(p<0.0005)。放射性碘治疗后、48小时及1个月,CA 19-9的AFP结果分别为9.30±6.32、9.95±6.92(p=0.040)和11.26±7.49(p<0.001)。CEA结果分别为1.60±0.60、1.47±0.55和2.23±0.69(p<0.0005)。在肿瘤标志物CA 15-3的情况下,结果分别为15.53±6.48和1.60±0.60和15.68±6.52(p=0.014),在ALP的情况下结果分别为124.22±5和122.2±6和116.7±7(p<0.0005)。结论:根据相同的研究和获得的结果,可以认为肿瘤标志物CEA和CA19-9在监测癌症患者的恶性和进行性疾病方面是更可接受和更可持续的。ALP下降是正常的和瞬态的。AFP和CA15-3的升高甚至在统计学上都不可靠。在对癌症甲状腺患者进行胃肠道研究期间,建议将碘治疗和肿瘤标志物虚高的时间告知医生,以防止在治疗过程中做出错误决定。
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Evaluation of Serum Tumor Markers Variation, Following The Radioactive Iodine Therapy in Patients with Differentiated Thyroid Cancer
Introduction: Radioactive iodine is the effective therapy in thyroid cancer. The aim of this study is to evaluate the serum tumor markers in patients under the therapy with radioactive iodine 131. Material and Methods: 45 cases of female patients aged 16-60 years with thyroid cancer surgery referred to the nuclear medicine department of Nemazi hospital for (iodine treatment after surgery) were selected. The selection was on the basis of interviewing and information of patients is consent forms. Only patients with thyroid cancer and referred for the first time without any other diseases were chosen for this study. The selected patients were prescribed a dose of 150 m Ci of I-131. From each patient, 4 mL of chelated serum for serological studies on tumor markers and 2 mL of oxalated serum for spectrophotometry studies on cell death were used in three stages. The first stage before the iodine therapy, the second stage, after 48 hours, and the third stage, 30 days after radioiodine therapy were studied and the results were evaluated by the one-way repeated measures ANOVA test. Results: According to the results of dependent paired T-Test, AFP, in the periods before, 48 hours and 1 month after radioiodine therapy, respectively were 3.46 ± 1.21 and 3.74 ± 1.37 and 3.76 ± 1.25 (p <0.0005). About CA 19-9 in the periods before, 48 hours and one month after radioiodine therapy, the results were 9.30 ± 6.32, 9.95 ± 6.92 (p = 0.040) and 11.26 ± 7.49 (p <0.0005) respectively. About CEA, the results were 1.60 ± 0.60, 1.47 ± 0.55 and 2.23 ± 0.69 (p <0.0005), respectively. In the case of tumor marker CA 15-3 results were 15.53 ± 6.48 and 1.60 ± 0.60 and 15.68 ± 6.52 (p = 0.014), respectively and in the case of ALP, results were 124.22 ± 5 and 122.2 ± 6 and 116.7 ± 7 (p <0.0005), respectively. Conclusion: According to the same studies and the acquired results, it can be concluded that the tumor markers CEA and CA19-9 are more acceptable and sustainable for monitoring the malignancy and progressive disease in patients with thyroid cancer. The decreasing ALP is normal and transient. The increase of AFP and CA15-3 is not even statistically reliable. It is recommended that the period of iodine therapy and falsely elevated tumor markers can be informed to the doctor, during the gastrointestinal studies in patients with thyroid cancer, in order to prevent wrong decisions on the treatment process.
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