甲状腺髓样癌术后的病情监测

目的 研究判断甲状腺髓样癌（ＭＴＣ）患者手术是否成功以及残二定位的方法。方法 对１４例ＭＴＣ术后的患者进行了钙负荷－降钙素激发试验,并检测血癌胚怕（ＣＥＡ）、胃泌素（ＧＳＴ）、肠血管活性肽（ＶＩＰ）,同时对降钙素增高的患者进行生长抑素受体核素显像。结果 １４例２钙负荷－降钙素激发试验后降钙素峰值均升高,其中７例２降钙素基因值异常升高（６９．７－１６６９．１ｎｇ／Ｌ）,峰值更高;对其７例进一步进行Ｓ

Detection of remnants after removal of medullary thyroid carcinoma

OBJECTIVE: To assess whether calcium stimulation test or somatostain-receptor (SS-R) imaging could early detect remnants after removal of medullary thyroid carcinoma (MTC). METHODS: Calcitonin stimulation (calcium element 3 mg/kg weight, i.v. 10 min), carcino-embryonic antigen (CEA), gastrin (GST) and vasoactive intestinal peptide (VIP) were tested in 14 patients with postoperative MTC. SS-R imaging was used to localize the remnants after removal of MTC in patients with elevated calcitonin. RESULTS: Calcitonin stimulation test showed that the peak value of serum calcitonin was elevated in all patients, of whom 7 had the elevated vatue of basic calcitonin and peak calcitonin. In the 7 patients, SS-R imaging showed normal CEA, GST and VIP. CONCLUSIONS: It is necessary for patients after removal of MTC to perform calcitonin stimulation test for detecting remnants early. SS-R imaging may be useful for localizing remnants and metastatic foci. CEA, GST and VIP are not significant in monitoring MTC after operation.