对分化型甲状腺癌在~(131)I治疗后随访工具的评价

目的本文回顾性的评价了2002-2010年在我科进行131I治疗的124例分化型甲状腺癌的随访结果,对血清TSH刺激甲状腺球蛋白(Tg)测定及131I全身扫描(WBS)两项重要的随访工具的可靠性作出评价。方法将血清TSH刺激甲状腺球蛋白(Tg)测定及131I全身扫描(WBS)两项结果用SPSS软件进行一致性分析。结果血清TSH刺激甲状腺球蛋白(Tg)测定与131I全身扫描(WBS)对DTC复发或转移的诊断一致性的检验结果:kappa值为0.587,SE=0.076,P<0.0001。检验结果表明这两种随访工具之间虽然存在一定的一致性,但并不十分理想。结论由于血清抗甲状腺球蛋白抗体(TgAb)的干扰,在进行血清Tg测定的同时必须做血清TgAb的测定,并且血清TSH刺激Tg及TgAb测定常出现假阴性,因此,131I全身扫描是不可缺少的重要随访工具。

Evaluation of follow-up tools for patients with differentiated thyroid cancer after 131Iodine therapy

【Objective】 This paper retrospectively evaluated the results of follow-up of 124 patients with differentiated thyroid cancer(DTC) who were treated by 131Iodine in our department between 2002-2010.The purpose is to evaluate reliability of the follow-up tools of serum TSH stimulating thyroglobulin(Tg) test and 131Iodine whole body scan(WBS).【Methods】 By SPSS software,Kappa test were performed between results of serum Tg,TgAb test and WBS for diagnosis of persistent/recurrent DTC.【Results】 Consistency test of TSH stimulating Tg,TgAb and 131Iodine whole body scan for diagnostic persistent/recurrent or metastasis of DTC:kappa value=0.587 SE=0.076 P<0.0001.Although the result showed that two measurements appeared definite consistency,it is dissatisfactory.【Conclusion】 serum TSH stimulating thyroglobulin(Tg) test and 131Iodine whole body scan(WBS) are important follow-up tools for patients with DTC.Because of Tg interfering it is necessary to performed TgAb test simultaneously,when Tg test was performed.Especially 131Iodine whole body scan do is not absent because false negative would be able to appeared in single serum TSH stimulating Tg and TgAb test.