AUTHOR=Xu Xiang , Li Chengqian , Yu Xiaolong , Wang Guoqiang , Guo Yanjun , Ni Huaiwen , Zhao Wenjuan , Wang Yangang , Dong Bingzi 

TITLE=Clinicopathological features affecting the efficacy in 131I ablation therapy of papillary thyroid carcinoma with lymph node metastasis

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2024.1382009

DOI=10.3389/fendo.2024.1382009

ISSN=1664-2392

ABSTRACT=Background: Lymph node metastasis is the major cause of increased recurrence and death in papillary thyroid carcinoma (PTC) patients. We evaluate the clinicopathologic factors affecting excellent response (ER) in PTC patients with lymph node metastasis following operation and 131 I ablation therapy.: 423 PTC patients with lymph node metastasis who underwent thyroidectomy and postoperative 131 I ablation therapy were enrolled. The relationship between clinicopathological factors affecting ER achievement was analyzed. Results: Multivariate analysis showed that the foci diameter (≤1cm), unifocal, combination with Hashimoto's thyroiditis (HT), lymph node metastases rate (LR) (≤40%), no postoperative 131 I ablation lymph node metastasis, low preablative stimulated thyroglobulin (ps-Tg) level (≤3.87ng/mL), and the time of 131 I ablation therapy (1 time) were positively correlated with the ER achievement (OR: 1.744, 3.114, 3.920, 4.018, 2.074, 9.767, 49.491, all p<0.05). The receiver operating characteristic (ROC) curves showed that the cut-off values of ps-Tg and LR were 4.625 ng/mL and 50.50%, respectively. The AUC of ROC of ps-Tg and LR for predicting ER achievement was 0.821 and 0.746. The Tg and the cumulative risk of non-ER elevated with the increase of LR, especially for the high-level ps-Tg (>4.625 ng/mL) group.The foci diameter and number, combination with HT, LR, and ps-Tg level are independent factors for ER. Ps-Tg level and LR are valid predictive factors for the efficacy of 131 I therapy in PTC patients. The predictive value of the cumulative risk of non-ER can be improved by combination of ps-Tg and LR.