Analysis of Curative Effect and Influencing Factors of N1 Stage Papillary Thyroid Micro-Carcinoma and Papillary Thyroid Non-Micro Carcinoma After Initial Radioactive Iodine Ablation Therapy

Figures & data

Table 1 Clinical Implications of Response to Therapy Reclassification in Patients with Differentiated Thyroid Cancer Treated with Total Thyroidectomy and Radioiodine Remnant Ablation

Category	Definitions
Excellent response (ER)	Negative imaging and either suppressed Tg< 0.2 ng/mL or stimulated Tg< 1 ng/mL
Biochemical incomplete response (BIR)	Negative imaging and suppressed Tg ≥1 ng/mL or stimulated Tg ≥10 ng/mL or rising anti-Tg antibody levels
Structural incomplete response (SIR)	Structural of functional evidence of disease with any Tg level with or without anti-Tg antibodies
Indeterminate response (IDR)	Non-specific findings on imaging studies; faint uptake in thyroid bed on RAI scanning; non-stimulated Tg detectable, but < 1 ng/mL; stimulated Tg detectable, but < 10 ng/mL or anti-Tg antibodies stable or declining in the absence of structural or functional disease

Table 2 General Data of PTC and PTMC and the Relationship Between Lymph Node Metastasis and Treatment Response

	PTC (n = 214)	PTMC (n = 129)	χ^2	P
Male (case)	61 (28.5%)	38 (29.5%)	0.036	0.85
Female (case)	153 (71.5%)	91 (70.5%)
Age (years)	41.71±11.75	42.78±10.52		0.401
≥ 55 (case)	25 (11.7%)	20 (15.5%)	1.031	0.31
< 55 (case)	189 (88.3%)	109 (84.5%)
ETE (case)	47 (22%)	22 (17.1%)	1.207	0.272
No ETE (case)	167 (78%)	107 (82.9%)
HT (case)	23 (10.7%)	12 (9.3%)	0.183	0.668
No HT (case)	191 (89.3%)	117 (90.7%)
Single lobe (case)	115 (53.7%)	69 (53.5%)	0.002	0.964
Double lobe (case)	99 (46.3%)	60 (46.5%)
TT (day)	71 (58, 89)	77 (62.5, 93)		0.06
Urinary iodine level (ug/L)	103 (59.8, 195.4)	95.5 (64.9, 167.5)		0.44
ps-TSH (uIU/mL)	98.91 (72.88, 100.00)	98.30 (71.46, 100.00)		0.9
ps-Tg (ng/mL)	7.67 (4.8, 16.97)	3.51 (1.36, 10.12)		0.001
N1a ps-Tg (ng/mL)	7.39 (4.75, 13.57)	3.19 (1.22, 9.54)		0.001
N1b ps-Tg (ng/mL)	9.09 (4.95, 23.22)	4.39 (1.88, 14.38)		0.006
Total ER (case)	117 (54.7%)	87 (67.4%)	5.445	0.02
Total NER (case)	97 (45.3%)	42 (32.6%)
N1a ER (case)	68 (66.7%)	58 (80.6%)	4.076	0.044
N1a NER (case)	34 (33.3%)	14 (19.4%)
N1a Lymph node metastasis ≥ 3 ER (case)	20 (54.1%)	14 (70%)	1.372	0.242
N1a Lymph node metastasis ≥ 3 NER (case)	17 (45.9%)	6 (30%)
N1b ER (case)	49 (43.8%)	29 (50.9%)	0.772	0.38
N1b NER (case)	63 (56.2%)	28 (49.1%)
N1b Lymph node metastasis ≥ 3 ER (case)	24 (31.6%)	16 (38.1%)	0.513	0.474
N1b Lymph node metastasis ≥ 3 NER (case)	52 (68.4%)	26 (61.9%)

Abbreviations: PTC, papillary thyroid non-micro carcinoma; PTMC, papillary thyroid micro-carcinoma; ps-TSH, preablative-stimulated TSH; ps-Tg, preablative-stimulated thyroglobulin.

Figure 1 With the stage from N1a to N1b and the number of lymph node metastases increasing, the percentage of ER gradually decreased and the percentage of NER gradually increased.

Table 3 Comparison of PTC and PTMC After Being Divided into ER and NER Groups

	ER (PTC)	NER (PTC)	χ^2	P	ER (PTMC)	NER (PTMC)	χ^2	P
Male (case)	22 (36.1%)	39 (63.9%)	11.92	0.001	18 (47.4%)	20 (52.6%)	9.885	0.002
Female (case)	95 (62.1%)	58 (37.9%)			69 (75.8%)	22 (24.2%)
Age (years)	41.7 ± 11.54	41.73 ± 12.05		0.985	43.48 ± 10.61	41.31 ± 10.29		0.273
≥ 55 (case)	13 (52%)	12 (48%)	0.082	0.775	16 (80%)	4 (20%)	1.7	0.192
< 55 (case)	104 (55%)	85 (45%)			71 (65.1%)	38 (34.9%)
TT (day)	74 (59, 90.75)	66 (57, 88)		0.143	75 (62, 95)	79 (66.75, 88)		0.962
>90 days	29 (64.4%)	16 (35.6%)	2.196	0.138	26 (72.2%)	10 (27.8%)	0.52	0.471
≤ 90 days	88 (52.1%)	81 (47.9%)			61 (65.6%)	32 (34.4%)
Urinary iodine level (ug/L)	106 (70.7, 200.7)	97.2 (57.55, 175.8)		0.154	95.4 (64, 178.2)	103.5 (66.7, 166.75)		0.642
ps-TSH (uIU/mL)	97.34 (67.41, 100)	99.4 (73.25, 100)		0.725	98.01 (71.88, 100)	100 (69.99, 100)		0.934
ps-Tg (ng/mL)	5.39 (4.33, 8.84)	15.46 (7.67, 34.68)		0.001	3.1 (1.21, 9.7)	4.275 (2.28, 17.07)		0.007
Maximum diameter (cm)	1.5 (1.2, 2.0)	1.5 (1.2, 2.45)		0.251	0.5 (0.5, 0.8)	0.7 (0.5, 0.8)		0.206
PTC > 2cm (case) PTMC > 0.5cm (case)	25 (45.5%)	30 (54.5%)	2.538	0.111	41 (59.4%)	28 (40.6%)	4.347	0.037
PTC ≤2cm (case) PTMC ≤0.5cm (case)	92 (57.9%)	67 (42.1%)			46 (76.7%)	14 (23.3%)
ETE (case)	26 (55.3%)	21 (44.7%)	0.01	0.92	12 (54.5%)	10 (45.5%)	2.009	0.156
No ETE (case)	91 (54.5%)	76 (45.5%)			75 (70.1%)	32 (29.9%)
HT (case)	10 (43.5%)	13 (56.5%)	1.303	0.254	8 (66.7%)	4 (33.3%)		0.952
No HT (case)	107 (56%)	84 (44%)			79 (67.5%)	38 (32.5%)
Single lobe (case)	70 (60.9%)	45 (39.1%)	3.852	0.05	44 (63.8%)	25 (36.2%)	0.912	0.34
Double lobe (case)	47 (47.5%)	52 (52.5%)			43 (71.7%)	17 (28.3%)
N1a (case)	68 (66.7%)	34 (33.3%)	11.31	0.001	58 (80.6%)	14 (19.4%)	12.76	0.001
N1b (case)	49 (43.8%)	63 (56.2%)			29 (50.9%)	28 (49.1%)

Table 4 Multivariate Logistic Regression Analysis on the RAI Treatment Response in PTC and PTMC

	β	OR (95% CI)	P
PTC
Gender (male)	0.922	2.515 (1.248, 5.068)	0.01
N (N1b)	0.787	2.197 (1.151, 4.194)	0.017
ps-Tg	0.095	1.099 (1.062, 1.138)	0.001
PTMC
Gender (male)	1.274	3.575 (1.483, 8.617)	0.005
N (N1b)	1.428	4.169 (1.779, 9.766)	0.001
ps-Tg	0.029	1.029 (1.000, 1.059)	0.049

Figure 2 ROC curve of the relationship between ps-Tg and RAI response in patients with PTC and PTMC.