Cell-mediated immunity to gluten fraction III in adult coeliac disease.
Authors: A W Bullen, M S Losowsky
Journal: Gut (1978)

<b>3006</b> <h3><b>Introduction:</b></h3> To investigate&amp;nbsp;the influence factors of excellent response&amp;nbsp;in patients with circulating thyroglobulin antibodies（TgAb）positive with&amp;nbsp;papillary thyroid cancer (PTC) with post-thyroidectomy with radioactive iodine therapy. <h3><b>Methods:</b></h3> A total of 129 patients with PTC who were positive for TgAb and&amp;nbsp;who received radioactive iodine therapy in the Department of Nuclear Medicine, The First Hospital of Shanxi Medical University from November 2014 to September 2020 were retrospectively analyzed, including 103 females and 26 males, aged from 13 to 70 (43.9±11.9) years.&amp;nbsp;The serological indexes such as thyroglobulin (Tg) and TgAb before and after radioactive iodine therapy and the imaging results of <sup>131</sup>I whole-body imaging and neck ultrasound were collected.&amp;nbsp;&amp;nbsp;The patients were divided into three groups according to the change of TgAb level from 6 to 12 months after radioactive iodine therapy. The increased group: TgAb value increased by more than 20%;&amp;nbsp;&amp;nbsp;The decreased group: TgAb value decreased by more than 20%;&amp;nbsp;&amp;nbsp;The stable group&amp;nbsp;: TgAb value increased or decreased by less than 20%.&amp;nbsp;The median follow-up time of all patients was&amp;nbsp;32 (14-85) months. At the end of the follow-up, according to the therapeutic efficacy response evaluation system of ATA Guidelines&amp;nbsp;the response to therapy was&amp;nbsp;divided into excellent response (ER)&amp;nbsp;group (n=69)and non-excellent&amp;nbsp;response (nER) group (n=60).&amp;nbsp;Age, sex, the size of tumor, TgAb level before radioactive iodine therapy, the&amp;nbsp;change of&amp;nbsp;TgAb level in short-term&amp;nbsp;after radioactive iodine therapy, recurrence-risk stratification, TNM stage, unifocal or multifocal, unilateral or&amp;nbsp;bilateral, extrathyroidal extension, and whether or not Hashimoto9s was involved were statistically analyzed.&amp;nbsp;&amp;nbsp;Chi-square test, Fisher9s exact probability test, Mann-Whitney U test and receiver operating characteristic (ROC) curve were used.&amp;nbsp;P&lt;0.05 was considered statistically significant. <h3><b>Results:</b></h3> 1.There were statistically significant differences between ER group and nER group in the size of tumor (z=-2.230, P=0.026), TgAb level before radioactive iodine therapy (z=-3.786, P=0.000) and the change of TgAb level in short-term after radioactive iodine therapy (P=0.000).&amp;nbsp;There were no significant differences in age, gender, recurrence-risk stratification, TNM stage, unifocal or multifocal, unilateral or bilatera, extrathyroidal extensiont, and whether or not Hashimoto9s&amp;nbsp;(all P&gt;0.05)(Table 1).&amp;nbsp;&amp;nbsp; 2.ROC curve analysis showed the change of TgAb level in short-term after radioactive iodine therapy, TgAb level before radioactive iodine therapy, and TgAb level before radioactive iodine therapy in non-Hashimoto9s&amp;nbsp;patients had high diagnostic value for predicting the response&amp;nbsp;of radioactive iodine therapy.&amp;nbsp;The cut-off values were the short-term TgAb level decreased by &gt;44.5%, the TgAb level before treatment &lt; 304.4U/ mL, and the TgAb level before radioactive iodine therapy &lt;255.05U/ mL in non-Hashimoto9s&amp;nbsp;patients, the&amp;nbsp;sensitivity were&amp;nbsp;separately 83.3%, 60%, 54.1%;&amp;nbsp;the specificity were&amp;nbsp;separately 75.4%, 84.1%, 87.5%;&amp;nbsp;and the area under curve (AUC) were&amp;nbsp;separately 0.854, 0.701, 0.657 (Table 2). <h3><b>Conclusions:</b></h3> The patients with PTC who were positive for TgAb with small tumor maximum diameter, TgAb level decreased &gt; 44.5% after&amp;nbsp;radioactive iodine therapy and TgAb level &lt; 304.4U/ mL before radioactive iodine therapy have a better prognosis after radioactive iodine therapy and are more likely to obtain&amp;nbsp;ER.