放射性碘（RAI）治疗是甲状腺乳头状癌（PTC）患者甲状腺全切除术后的标准治疗方法。我们的目的是确定中危和高危 PTC 患者治疗反应的预测因素。此外，还探讨了多种 RAI 治疗的影响。在一项为期 3 年的回顾性研究中，对甲状腺全切除术后接受 RAI 治疗的 PTC 中危和高危患者的数据进行了分析。三。研究人员对人口统计学数据、肿瘤大小、被膜/血管侵犯、甲状腺外扩展、局部或远处转移、RAI初始剂量和累积剂量、血清甲状腺球蛋白（Tg）、抗甲状腺球蛋白抗体（TgAb）和影像学结果进行了研究。经过三年的随访，对单剂 RAI 治疗有良好反应的患者被归类为“反应组”。优异的反应被定义为在影像学扫描呈阴性的 TgAb 阴性患者中，刺激后血清 Tg 低于 1 ng/ml，或未刺激血清 Tg 低于 0.2 ng/ml。本研究分析了 333 份具有完整数据集的患者记录。经过三年的初始治疗后，271 名患者为无反应者 (NR)，62 名患者为反应者 (R)。基线时，NR 组中位消融前血清 Tg 水平为 5.7 ng/ml，R 组为 1.25 ng/ml（P < 0.001）。 TSH刺激的血清Tg大于15.7 ng/ml，即使在多次RAI治疗后也与反应失败相关，AUC：0.717（0.660-0.774），敏感性：52.5%，特异性：89.47%，P < 0.001。另一方面，16.2% 的患者在多次 RAI 治疗中获得了良好的反应。如果最初的术后超声检查证实存在局部区域受累，则 ER 的几率会降低 74%，OR 0.26，（95% CI：0.12-0.55），P < 0.001。甲状腺全切除术后刺激的血清 Tg 和局部区域受累是中高危 PTC 患者对 RAI 治疗无反应的预测因素。此外，少数患者在多次 RAI 治疗后取得了良好的反应。© 2024。作者。

Radioactive iodine (RAI) therapy is the standard treatment approach after total thyroidectomy in patients with papillary thyroid carcinoma (PTC). We aimed to identify predictive factors of response to the treatment in intermediate and high-risk patients with PTC. In addition, the impact of multiple RAI treatments was explored.In a 3-year retrospective study, data from intermediate and high-risk patients with PTC who received RAI therapy following total thyroidectomy, were analyzed by the end of year-one and year-three. Demographic data, tumor size, capsular/vascular invasion, extrathyroidal extension, local or distant metastasis, initial dose and cumulative dose of RAI, serum thyroglobulin(Tg), antithyroglobulin antibody(TgAb), and imaging findings were investigated. Patients with an excellent response to a single dose of RAI treatment, after three years of follow-up were classified as the "Responder group". Excellent response was defined as stimulated serum Tg less than 1 ng/ml, or unstimulated serum Tg less than 0.2 ng/ml in TgAb-negative patients with negative imaging scans.333 patient records with a complete data set were analyzed in this study. After three years of initial treatment, 271 patients were non-responders (NR) and 62 were responders (R). At baseline, the median pre-ablation serum Tg level was 5.7 ng/ml in the NR group, and 1.25 ng/ml in the R group (P < 0.001). TSH-Stimulated serum Tg greater than 15.7 ng/ml, was associated with response failure even after multiple RAI therapy, AUC: 0.717(0.660-0.774), sensitivity: 52.5%, specificity: 89.47%, P < 0.001. On the other hand, multiple RAI therapy was associated with excellent response in 16.2% of the patients. The chance of ER was decreased by 74% if initial post-operation ultrasound imaging confirmed the presence of locoregional involvement, OR 0.26, (95% CI: 0.12-0.55), P < 0.001.Stimulated serum Tg and locoregional involvement after total thyroidectomy are predictive factors of non-response to RAI therapy in intermediate and high-risk patients with PTC. In addition, a minority of patients achieve excellent response after multiple RAI therapy.© 2024. The Author(s).