分化型甲状腺癌患者血清标志物的纵向变化及其与放射性核素治疗及临床特征的相关性分析OA

Objective:To investigate the longitudinal changes in serum thyroglobulin(Tg)and anti-thyroglobulin anti-body(TgAb)levels and their correlations with radioiodine(131 I)therapy and clinical characteristics in patients with differ-entiated thyroid cancer(DTC).Methods:A total of 180 DTC patients admitted to the Department of Nuclear Medicine of our hospital from January 2022 to January 2024,who received surgical treatment and met definite indications for 131 I therapy,were prospectively enrolled as research subjects.All patients received postoperative 131 I therapy and were routinely followed up for 12 months.Serum Tg and TgAb levels were measured before 131 I therapy and at 1,3,6,and 12 months after treat-ment,and their longitudinal trajectories were analyzed using a linear mixed model.At 12 months after treatment,clinical ef-ficacy was strictly judged in accordance with the response to therapy assessment systems proposed by the 2023 Chinese guide-lines and the 2025 American Thyroid Association guidelines.Patients were divided into a satisfactory efficacy group and an unsatisfactory efficacy group.Baseline data,clinical characteristics,and pre-treatment serum Tg and TgAb levels were com-pared between the two groups.Multivariate Logistic regression model was applied to analyze the relevant factors affecting pa-tient prognosis,and restricted cubic spline(RCS)curves were used to fit the correlation between the influencing factors and patient prognosis.Results:With time points set as fixed effects for random effect analysis,serum Tg levels at 1,3,6 and 12 months after treatment were(1.31±0.30)μg/L,(1.42±0.29)μg/L,(1.63±0.39)μg/L,(1.05±0.46)μg/L respectively;the corresponding serum TgAb levels were(1,235.46±256.12)IU/mL,(1,058.48±201.36)IU/mL,(896.74±158.32)IU/mL,(496.38±89.15)IU/mL respectively.Serum Tg rose significantly within 6 months after treatment and then dropped markedly at 12 months,while TgAb presented a continuous declining trend after treatment,with the maximum reduction observed at 12 months.Compared with the unsatisfactory efficacy group,patients in the satisfactory efficacy group were younger[(50.31±10.19)years vs(56.15±17.36)years],had shorter disease duration[(3.50±0.80)months vs(4.67±1.12)months],and had a lower metastasis rate(38.40%vs 56.36%)(P<0.05).The Tg[(1.28±0.31)ng/mL vs(1.98±0.54)ng/mL]and TgAb[(838.24±111.34)IU/mL vs(1,230.12±212.30)IU/mL]levels of the satisfactory efficacy group were also significantly lower(P<0.05).Age(OR=1.051,95%CI:1.001～1.102),disease duration(OR=3.991,95%CI:1.801～8.844),Tg(OR=3.624,95%CI:1.844～7.121),and TgAb(OR=1.409,95%CI:1.213～1.638)were relevant factors affecting the efficacy of 131 I therapy(P<0.05).RCS curves showed that disease duration,age,Tg,and TgAb were all nonlinearly correlated with the efficacy of 131 I therapy(P<0.05).Conclusion:131 I therapy in DTC patients is a dynamic process.Longitudinal trajectory analysis of serum Tg and TgAb levels,combined with age,disease duration,and the nonlinear patterns revealed by RCS models,can more accurately evaluate the response to 131 I therapy.