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目的:探讨儿童及青少年分化型甲状腺癌(DTC)患者术后首次n 131I治疗前刺激性甲状腺球蛋白(sTg)预测n 131I治疗效果的临床价值。n 方法:回顾性分析2009年1月至2018年12月间四川大学华西医院166例儿童及青少年DTC患者[男28例，女138例，年龄(16.5±3.0)岁]临床资料，所有患者均行甲状腺全切及n 131I治疗。n 131I治疗后6～12个月进行疗效评价，据治疗结果分为反应完全(ER)组与反应不完全(非ER)组。采用两独立样本n t检验、Mann-Whitney n U检验、n χ2检验或Fisher确切概率法比较2组间临床病理资料，行logistic回归分析影响n 131I治疗效果的独立因素，应用受试者工作特征(ROC)曲线评估sTg对疗效的预测价值。n 结果:ER患者61例，非ER患者105例。非ER组sTg水平明显高于ER组[52.5(11.8，259.1)和3.0(1.5，9.7) μg/L；n z＝6.508，n P<0.001]；2组患者的年龄、初始危险度分层、N分期、M分期、淋巴结转移比例及n 131I治疗剂量差异也有统计学意义(n t＝2.622和3.000，n z＝2.678, n χ2＝11.432和16.299；均n P<0.05)。sTg[比值比(n OR)＝1.156，n P＝0.002]及n 131I治疗剂量(n OR＝0.958，n P＝0.048)是影响n 131I治疗效果的独立因素。ROC曲线分析显示sTg预测疗效的最佳截断值为16.1 μg/L，灵敏度和特异性为72.4%(76/105)和96.7%(59/61)。n 结论:sTg可预测儿童及青少年DTC患者首次n 131I治疗效果，sTg≤16.1 μg/L时，获得ER的概率较高。n “,”Objective:To investigate the predictive value of stimulated thyroglobulin (sTg) before the first n 131I therapy for children and adolescents with differentiated thyroid carcinoma(DTC).n Methods:Between January 2009 and December 2018, a total of 166 children and adolescents DTC patients (28 males, 138 females; age (16.5±3.0) years) from West China Hospital of Sichuan University were retrospectively analyzed. All patients underwent total thyroidectomy and n 131I therapy. According to the treatment response evaluated 6-12 months after n 131I therapy, patients were divided into excellent response (ER) group and incomplete response (non-ER) group. Clinical and pathological characteristics of 2 groups were compared using independent-sample n t test, Mann-Whitney n U test, n χ2 test or Fisher′s exact test. The independent predictors for n 131I treatment response were analyzed by logistic regression analysis. The cut-off value of sTg for predicting ER was determined by receiver operating characteristic (ROC) curve analysis.n Results:Sixty-one patients achieved ER, while treatment response in 105 patients was non-ER. The level of sTg in non-ER group was significantly higher than that in ER group (52.5(11.8, 259.1) and 3.0(1.5, 9.7) μg/L; n z=6.508, n P<0.001). In addition, age, risk stratification, N stage, M stage, ratio of invaded lymph nodes and activities ofn 131I administered were also significantly different between those 2 groups (n t=2.611, 3.000, n z=2.678, n χ2=11.432, 16.299; all n P<0.05). The level of sTg (odds ratio (n OR)=1.156, n P=0.002) and administered activity of n 131I (n OR=0.958, n P=0.048) were independent predictors for the responses. ROC curve analysis showed that the best cut-off value of sTg for predicting ER was 16.1 μg/L with the sensitivity of 72.4%(76/105) and the specificity of 96.7%(59/61).n Conclusions:sTg has the capability of predicting the response to the first n 131I therapy in children and adolescents with DTC. When sTg is lower than 16.1 μg/L, the probability of ER increases.n