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The influence of stimulated thyroglobulin and lymphocyte subsets before radioiodine therapy on the therapeutic response in patients with intermediate- and high-risk papillary thyroid carcinoma

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Abstract

The aim of the present study was to investigate the factors influencing the short-term response to the initial radioiodine therapy (RT) course in patients with intermediate- and high-risk papillary thyroid carcinoma (PTC). A total of 182 patients with intermediate- and high-risk PTC who underwent RT in our hospital from March 2018 to October 2020 were retrospectively enrolled. The patients were divided into incomplete response (IR) and nonincomplete response (Non-IR) groups according to the response observed in clinical follow-up within 6–12 months after RT. Univariate and multivariate logistic regression analyses were used to investigate the effects of 15 observed factors on the response to RT. Receiver operating characteristic (ROC) curve analysis was used to determine the value of factors found to be significant in multivariate analyses for predicting an IR. A total of 182 patients with intermediate- and high-risk PTC were analyzed; the percentage of patients with a Non-IR was 61.54% (112/182), and the percentage of patients with an IR was 38.46% (70/182). The CD4+ T-cell percentage (t = 4.757, P = 0.000), CD4/CD8 (z = − 2.632, P = 0.008), stimulated thyroglobulin (sTg) level (z = − 8.273, P = 0.000) and M stage (χ2 = 17.823, P = 0.000) of the two groups were significantly different. Multivariate analysis showed that only the sTg level (OR: 1.116, 95% CI 1.068–1.165, P < 0.001) and CD4+ T-cell percentage (OR: 0.909, 95% CI 0.854–0.968, P = 0.003) were independent factors associated with the therapeutic response to RT. The cutoff sTg level and CD4+ T-cell percentage for predicting an IR were 7.62 μg/L and 40.95%, respectively. The sTg level and CD4+ T-cell percentage were verified to be independent predictive factors of RT response. Higher sTg levels and lower CD4+ T-cell percentages were related to an IR in patients with intermediate- and high-risk PTC.

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Data availability statement

The datasets used during the present study are available from the corresponding author upon reasonable request.

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Acknowledgements

We acknowledge the substantial contributions of the physicians and staff members of the Nuclear Medicine Department at the Affiliated Hospital of Qingdao University who participated in these patients' management and follow-up.

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The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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  1. Chenghui Lu and Congcong Wang contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao, 266003, Shandong, China

    Chenghui Lu, Congcong Wang, Fengqi Li, Xinfeng Liu, Guoqiang Wang, Jiao Li, Zenghua Wang, Na Han, Yingying Zhang, Zengmei Si & Xufu Wang

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Contributions

CL, CW and XW contributed to the conception and design of the study. YZ, ZS, NH and JL assisted with data acquisition. CL, CW and XW conducted the statistical analyses and drafted the manuscript. FL, XL, GW and ZW critically revised the manuscript. CL and CW contributed equally to this work. All authors contributed to the article and approved the submitted version.

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Correspondence to Xufu Wang.

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Ethics statement

The studies involving human participants were reviewed and approved by Ethical Committee of the Affiliated Hospital of Qingdao University. Written informed consent to participate in this study was provided by the participants’ legal guardian/next of kin.

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Written informed consents were provided by the participants to enter this study, so every people participated in our study voluntarily and comprehended all aspects of the research.

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Lu, C., Wang, C., Li, F. et al. The influence of stimulated thyroglobulin and lymphocyte subsets before radioiodine therapy on the therapeutic response in patients with intermediate- and high-risk papillary thyroid carcinoma. Clin Exp Med 23, 2193–2200 (2023). https://doi.org/10.1007/s10238-022-00932-y

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