RESUMO
BACKGROUND: Radioactive iodine (RAI) ablation is recommended for most patients with differentiated thyroid carcinoma (DTC) after total thyroidectomy (TT). We aimed to compare long-term outcomes between intermediate-dose (100 mCi) and high-dose (150 mCi) RAI ablation therapy in patients with DTC using propensity score matching analysis. METHODS: This was a retrospective study of 1448 patients with DTC who underwent RAI ablation after TT. Propensity score matching was performed using the extent of operation, tumor size, extrathyroidal extension, multifocality, lymphatic invasion, vascular invasion, perineural invasion, number of positive lymph nodes (LNs), ATA risk stratification system, T stage, N stage, TNM stage, preoperative serum Tg and TgAb levels, and post-RAI serum Tg and TgAb levels. RESULTS: Recurrence rates in the intermediate- and high-dose groups were 3.1% and 5.6%, respectively. After propensity score matching, LN ratio >0.22 (HR, 2.915; 95% CI, 1.228-6.918; p=0.015) and serum Tg >10 ng/mL after RAI (HR, 3.976; 95% CI, 1.839-8.595; p < 0.001) were significant predictors of recurrence. Kaplan-Meier analysis showed no significant difference in DFS before or after propensity score matching (p=0.074 and p=0.378, respectively). CONCLUSIONS: Intermediate-dose RAI ablation for the adjuvant treatment of DTC is sufficient as compared to high-dose RAI ablation. Further prospective or multicenter studies should be conducted to clarify the prognosis of intermediate-dose RAI ablation.
RESUMO
BACKGROUND & AIMS: Hepatic ischemia/reperfusion (I/R) injury may activate innate immunity through the interaction of toll-like receptor 4 (TLR4) with endogenous ligands. Omega-3 polyunsaturated fatty acids (ω-3 PUFAs) exert suppressive effects on innate immunity through various mechanisms. In this study, we investigated the effect of dietary supplementation with ω-3 PUFAs on hepatic I/R in rats. METHODS: Three groups of Wistar male rats were fed a standard diet with water, and fish oil as ω-3 PUFAs, or soybean oil as ω-6 PUFAs for 7 days. Subsequently, the rats underwent normothermic, 60 min, partial liver ischemia followed by 6 h of reperfusion. The activation of TLR4 signaling was evaluated using membrane lipid raft isolation. After the 6 h of reperfusion, histopathologic alterations, serum ALT levels, TLR4-mediated inflammation were assessed by western blotting and immunohistochemical study. RESULTS: The damage of liver from I/R was diminished by dietary fish oil supplementation. Administration of fish oil inhibited TLR4 receptor recruitment into lipid rafts of cell membrane in liver tissues, which is an initial step required for activation of the downstream signaling pathway. Down-regulation of TLR4-mediated signaling reduced NF-κB activation and consequently, improved I/R injury. CONCLUSIONS: Dietary ω-3 PUFAs supplementation attenuated hepatic I/R injury and could be considered as a nutritional therapeutic aimed at ameliorating I/R injury.