分化型甲状腺癌术后大剂量131I治疗的必要性

 目的　分析分化型甲状腺癌（DTC）甲状腺切除术后大剂量131I清除剩余甲状腺组织（清甲）的必要性。方法　对257例DTC患者资料进行回顾性分析。根据手术方式及术后是否用131I清甲治疗,将257例DTC患者分为3组,A组：甲状腺全部切除+甲状腺素片抑制治疗患者72例,B组：甲状腺全部切除+ 131I清甲+甲状腺素片抑制治疗患者98例,C组：甲状腺部分切除+131I清甲+甲状腺素片抑制治疗患者87例,平均随访时间为7.4年,比较各组患者在随访期间的复发率。结果　A组、B组、C组的复发率分别为15.2 %（11／72）、5.1 %（5／98）、5.7 %（5／87）,A组与B、C组相比差异均有统计学意义（χ2值分别为4.36、3.95,P值均＜0.05）,B组与C组相比差异无统计学意义（P＞0.05）。B组首次131I清甲的成功率为85.7 %（84／98）,清甲的次数1～3次,累积剂量为3.7～11.1 GBq（100～300 mCi）,C组首次清甲的成功率为64.4 %（56／87）,清甲的次数为1～5次,累积剂量为3.7～22.2 GBq（100～600 mCi）,C组清甲次数及累及剂量高于B组。结论　DTC后131I清甲治疗是非常有必要的,对于手术全部切除困难或错过全切时机的患者,甲状腺部分切除+131I清甲治疗应作为DTC的一种可选择的治疗方案。     

甲状腺癌131I清甲治疗前后Tg及TgAb测定值分析

摘 要：［目的］ 分析甲状腺癌131I清甲治疗后随访中甲状腺球蛋白（Tg）及甲状腺球蛋白抗体（TgAb）变化的意义。［方法］ 回顾性80例甲状腺癌患者,行甲状腺全切术或次全切术加淋巴结清扫术后实施131I清甲治疗前1d和治疗后7d及治疗后半年Tg和TgAb水平变化情况。［结果］ 术前Tg阳性组37例患者治疗前1d和治疗后7d的 Tg和TgAb水平明显高于131I清甲治疗半年后和对照组的Tg和TgAb水平,而治疗后半年的Tg和TgAb水平与对照组比较差异无统计学意义（P＞0.05）。术前Tg阴性组43例患者治疗前1d和治疗后7d 的Tg和TgAb水平明显高于131I清甲治疗半年后和对照组的Tg和TgAb水平,而清甲治疗后半年的Tg和TgAb水平与对照组比较差异无统计学意义（P＞0.05）。阳性组治疗后有30例患者Tg水平转阴,转阴率81.08%。Tg水平和TgAb水平间无明显相关性（r=-0.068,P＞0.05）。术前阳性组缓解率（81.08%）低于阴性组（90.70%）,但差异无统计学意义（χ2=0.115,P=0.735）。［结论］ 甲状腺癌患者Tg水平和TgAb水平随着治疗后时间的延长下降趋势越明显。131I清甲治疗后加强对Tg和TgAb水平的监测对判断预后具有重要作用。     

甲状腺癌术后131I“清甲”投用剂量研究

摘 要：分化型甲状腺癌(DTC)术后使用131I去除残余功能性甲状腺组织（清甲）已被广泛应用,然而目前对于131I清甲投用剂量仍然存在一定争议。本文探讨分化型甲状腺癌(DTC)术后使用131I清甲投用的剂量问题,对比国内外相关研究的结果,总结并讨论131I在清甲中使用高低剂量的优缺点。     

分化型甲状腺癌患者术后放射性131I治疗效果的影响因素分析

目的 探讨分化型甲状腺癌(DTC)患者术后放射性131I治疗效果的影响因素.方法 选取115例手术后首次行131I治疗的DTC患者作为研究对象,根据治疗后131I全身显影结果将其分为清甲成功组与清甲未成功组,前者完全清除残余甲状腺组织,后者未完全清除残余甲状腺组织.影响因素分析先采用x2检验进行单因素分析,然后选择有统计学意义的指标进行非条件logistic回归分析.结果 115例DTC患者,其中51例患者在术后经首次131I治疗即成功清除残余甲状腺组织,治疗成功率为44.3％.清甲成功组与清甲未成功组性别、年龄、体质指数(BMI)、病理类型差异无统计学意义(P＞0.05),2组患者手术方式、131I首次治疗剂量、131I首次治疗前促甲状腺激素(TSH)以及甲状腺球蛋白(Tg)水平差异有统计学意义(P＜0.05).多因素非条件Logistic回归分析显示:131I首次治疗剂量、131I首次治疗前TSH以及Tg水平等指标是影响DTC患者术后放射性131I治疗效果的独立相关因素(P＜0.05),手术方式是非独立相关因素(P＞0.05).结论 131I首次治疗剂量、131I首次治疗前TSH以及Tg水平是影响DTC患者术后放射性131I治疗效果的重要因素.     

血清TgAb对分化型甲状腺癌消除甲状腺后Tg水平的影响

血清甲状腺球蛋白（thyroglobulin,Tg）测定是判断分化型甲状腺癌（differentiated thyroid carcinoma,DTC）术后和^131 I治疗后有无复发的重要指标,而Tg测定均受到甲状腺球蛋白抗体（TgAb）的干扰。本研究对98例DTC患者在消除甲状腺后进行血清Tg、TgAb的检测检查,结果报道如下。     

分化型甲状腺癌术后患者131I治疗效果评估

目的：对分化型甲状腺癌术后患者131I治疗效果进行评估。方法：对136例术后病理结果为分化型甲状腺癌的患者分别给予口服131I治疗,次数1-3次不等,并于治疗后1周给予甲状腺激素替代治疗,治疗后4-6个月后评估治疗效果。结果：经1次131I治疗后,完全清除残留甲状腺58例（41.91%）,2次131I治疗后,完全清除残留甲状腺87例（63.97%）,3次131I治疗后,完全清除残留甲状腺达到123例（90.44%）,不完全清除12例,无效1例。对甲状腺癌转移灶,经3次131I治疗后,淋巴结转移有效率最高,达90.44%,骨骼转移有效率为55.56%,有效率最低。结论：对DTC术后患者行131I治疗,大部分患者（90.44%）3次即可完全清除残留甲状腺组织;甲状腺癌转移灶经3次131I治疗后,可取得55.56%-90.44%不等有效率。     

甲状腺球蛋白抗体(TgAb)在分化型甲状腺癌临床诊疗中应用的研究进展

甲状腺癌是内分泌系统最为常见的恶性肿瘤,近年来甲状腺癌的患病率持续增长,已成为全世界女性发病率增长最快的恶性肿瘤。分化型甲状腺癌(differentiated thyroid carcinoma, DTC)是甲状腺癌中最常见的类型。甲状腺球蛋白(thyroglobulin, Tg)是监测DTC手术和碘-131(¹³¹I)治疗后转移或者复发的血清肿瘤标志物。甲状腺球蛋白抗体(thyroglobulin antibody, TgAb)是甲状腺自身免疫的常规标志物,常见于慢性淋巴细胞性甲状腺炎,也有学者认为TgAb水平升高与甲状腺结节的恶性风险增加密切相关,是DTC的独立危险因素。DTC患者的TgAb阳性干扰了Tg的检测,从而限制了Tg在DTC患者监测中的作用。目前国际上大多数学者认为当血清Tg测定因TgAb出现而受干扰的情况下,TgAb水平可以当做DTC的替补肿瘤标志物。DTC患者术后TgAb水平的变化,不但在DTC转移有一定的预测价值,而且可以评估服用¹³¹I后的清甲疗效。此外,DTC术后随访时TgAb水平增高与DTC复发风险有所关联。因此本文...     

血清学标志物在分化型甲状腺癌治疗中的临床价值研究进展

甲状腺癌是最常见的头颈部及内分泌系统恶性肿瘤,大多数病理类型为乳头状及滤泡状,因其能够分泌甲状腺球蛋白,被称为分化型甲状腺癌(DTC)。大部分DTC预后良好,但部分亚型易复发及转移。血清甲状腺球蛋白(Tg)作为DTC复发及转移的监测指标具有重要意义。近年研究发现不仅术后清甲后Tg可以作为随访标志,术前促甲状腺激素(TSH)及Tg、术后清甲前血清Tg及术后清甲后甲状腺球蛋白抗体(TgAb)也有重要的临床价值。文章旨在将近几年关于血清学标志物在DTC术前、术后清甲前及术后清甲后等治疗过程中的应用进展进行综述。     

维甲酸诱导分化在分化型甲状腺癌治疗中的初步应用

目的探讨分化型甲状腺癌（DTC）放射性碘治疗过程中应用维甲酸（RA）治疗的作用。方法20例患者在^131I治疗期间由于全身^131I扫描显示肺或骨转移灶不摄取碘或摄碘能力不够不足以达到治疗目的，在下一次治疗前1．5个月服用RA。将RA治疗后^131I摄取较前增加的病例归为治疗有效组，而RA治疗后无^131I摄取或同前相比^131I摄取无变化的病例归为治疗无效组。应用配对t检验来比较RA治疗前后血清甲状腺球蛋白（Tg）的变化。结果20例患者共计25例次在^131I治疗期间服用RA，其中11例次（44％）治疗有效。治疗有效组的中位Tg值（382-1000ng／ml）较治疗无效组（176．35～616．25ng／ml）增高明显，但治疗前后Tg值进行统计学比较没有显著性意义（P〉0．05）。结论RA治疗能恢复DTC细胞的摄碘功能。     

分化型甲状腺癌术后131I清甲疗效相关影响因素分析

目的:探讨分化型甲状腺癌术后131I清甲疗效相关影响因素。方法:回顾性分析分化型甲状腺癌术后131I清甲治疗患者128例临床资料,总结包括年龄、性别、病理分型、手术切除方式、肿瘤转移、肿瘤转移部位、血清促甲状腺激素（TSH）水平及131I治疗时间等临床特征对疗效的影响。结果:对不同性别、年龄、病理分型及肿瘤转移有无进行分组比较,分化型甲状腺癌患者术后131I治疗临床疗效差异无统计学意义（P＞0.05）;而行甲状腺全切、肿瘤颈部淋巴结转移、血清TSH水平20~40mIU/L及131I治疗时间≤6个月组分化型甲状腺癌患者术后131I清甲临床疗效显著优于其他分组,差异有统计学意义（P＜0.05）;手术切除方式、血清TSH水平及131I治疗时间是影响分化型甲状腺癌术后131I治疗效果独立因素。结论:分化型甲状腺癌术后131I清甲疗效与手术切除方式、血清TSH水平及131I治疗时间具有相关性。     

Evaluation of the surgical completeness after total thyroidectomy for differentiated thyroid carcinoma.

BACKGROUND: To quantify the rate of patients without thyroid remnants, to identify predictive factors for the absence of residual thyroid tissue and to evaluate number, site, size and function of thyroid remnants after total thyroidectomy for differentiated thyroid carcinoma (DTC). METHODS: Thousand one hundred and seventy-eight patients who underwent total thyroidectomy for DTC were evaluated; 343 patients with lymph node or distant metastases and 115 patients with detectable thyroglobulin autoantibodies (TgAb) were excluded. (131)I ablative treatment (RAI) without preliminary diagnostic (131)I whole body scans (DxWBS), and 24-h (131)I quantitative neck uptake (RAIU test) and thyroglobulin (Tg) off L-T4 evaluation were performed in the remaining 720 pts. In 252 patients a 99mTc-pertechnetate pre-operative thyroid scan (99mTc-scan) was used for comparison with (131)I neck scans after RAI to evaluate site of thyroid remnants. Only patients with thyroid remnants were evaluated for successful ablation 6-10 months after RAI. RESULTS: Post-treatment whole body scan (TxWBS) demonstrated lack of thyroid remnants in 50/720 patients and the best predictive factors for the absence of residual thyroid tissue were RAIU <1% and undetectable Tg off L-T4. Thyroid remnants were present in 670/720 patients. In 252 patients with (99m)Tc-scan, 617 sites of functioning thyroid tissue were found: 381 within and 236 outside the thyroid bed. Complete successful ablation was achieved in 610/670 patients with thyroid remnants. CONCLUSIONS: This study confirms that most patients (93.1%) have thyroid remnant after total thyroidectomy for DTC. Most thyroid remnants were contralateral to tumour site and were even observed outside thyroid bed. However, a real total thyroidectomy, demonstrated by negative TxWBS, RAIU <1% and undetectable Tg off L-T4, was achieved in 6.9% of patients.     

Contemporary considerations in adjuvant radioiodine treatment of adults with differentiated thyroid cancer

Differentiated thyroid cancer (DTC) is the most common endocrine malignancy with a growing incidence worldwide. The initial conventional management is surgery, followed by consideration of ¹³¹I treatment that includes three options. These are termed remnant ablation (targeting benign thyroid remnant), adjuvant (targeting presumed microscopic DTC) and known disease (targeting macroscopic DTC) treatments. Some experts mostly rely on clinicopathologic assessment for recurrence risk to select patients for the ¹³¹I treatment. Others, in addition, apply radioiodine imaging to guide their treatment planning, termed theranostics (aka theragnostics or radiotheragnostics). In patients with low-risk DTC, remnant ablation rather than adjuvant treatment is generally recommended and, in this setting, the ATA recommends a low ¹³¹I activity. ¹³¹I adjuvant treatment is universally recommended in patients with high-risk DTC (a primary tumor of any size with gross extrathyroidal extension) and is generally recommended in intermediate-risk DTC (primary tumor >4 cm in diameter, locoregional metastases, microscopic extrathyroidal extension, aggressive histology or vascular invasion). The optimal amount of ¹³¹I activity for adjuvant treatment is controversial, but experts reached a consensus that the ¹³¹I activity should be greater than that for remnant ablation. The main obstacles to establishing timely evidence through randomized clinical trials for ¹³¹I therapy include years-to-decades delay in recurrence and low disease-specific mortality. This mini-review is intended to update oncologists on the most recent clinical, pathologic, laboratory and imaging variables, as well as on the current ¹³¹I therapy-related definitions and management paradigms, which should optimally equip them for individualized patient guidance and treatment.     

^131碘全身显像、甲状腺球蛋白测定及颈部超声检查在分化型甲状腺癌^131碘治疗随访中的意义

目的：探讨^131I一全身显像（^131I—WBS）、甲状腺球蛋白（Tg）测定及颈部B超检查在分化型甲状腺癌术后^131I治疗随访中的意义。方法：31例分化型甲状腺癌术后^131I治疗患者,治疗前后及随访中行甲状腺吸^131I率、颈部B超、^131I显像及甲状腺球蛋白测定。结果：治疗剂量^131I—WBS较诊断剂量^131I—WBS多发现3例转移灶;64人次Tg与^131I—WBS检查结果：Tg与^131I—WBS均阳性者19／64,均阴性者35／64,Tg阳性而^131I—WBS阴性者5／64,Tg阴性而^131I—WBS阳性者5／64;B超发现颈部淋巴结增大者为80．6％。结论：^131I治疗分化型甲状腺癌转移灶效果突出,^131I—WBS、Tg测定与颈部B超在其随访中联合应用可以相互补充,具有重要意义。     

术后分化型甲状腺癌131Ⅰ清甲治疗疗效及影响因素分析

目的：探讨手术后分化型甲状腺癌131Ⅰ清甲治疗的临床疗效及影响因素.方法：对376例分化型甲状腺癌患者行131Ⅰ治疗,并进行2-10年随访,以全身131Ⅰ扫描,甲状腺摄131Ⅰ率、血清TG浓度来评判清甲治疗疗效.结果：376例患者中266例1次131Ⅰ消融成功,1次成功率70.74％.1次消融有效病例333例,有效率为88.56％.消融无效病例43例,无效率11.44％.不同病理类型间一次消融率无统计学差异,不同治疗时间一次消融成功率有统计学差异.结论：甲状腺外科手术＋ 131Ⅰ＋ TSH抑制治疗的综合治疗方法在分化型甲状腺癌的治疗中有重要作用,外科手术方式和手术后到131Ⅰ治疗时间是疗效的重要影响因素.     

中低危分化型甲状腺癌低剂量131I治疗后短期转归的临床分析

背景与目的：2015版美国甲状腺协会（American Thyroid Association，ATA）指南首次提出治疗反应评估体系（response-to-therapy assessment system，RTAS）。该研究根据此评估体系，探讨低剂量（1 110 MBq）¹³¹I在中低危分化型甲状腺癌（differentiated thyroid carcinoma，DTC）清甲治疗后短期内不同转归的影响因素。方法：回顾性分析2015年1月—2017年1月166例中低危DTC患者资料，男性50例，女性116例，平均年龄（39.61±10.23）岁。首次清甲剂量为1 110MBq，取得清甲前及清甲后6~12个月刺激性甲状腺球蛋白（stimulated thyroglobulin，sTg）及诊断性全身显像（diagnosticwhole body scan，Dx-WBS），根据结果分为最佳治疗反应（excellent response，ER）组与非最佳反应（non-excellent response，NER）组。采用两样本t检验、Mann-Whitney U秩和检验及χ²检验进行组间临床病理资料比较，采用Logistic回归分析影响清甲疗效的因素，采用受试者工作特征（receiver operating characteristic，ROC）曲线确定最佳界值。结果：ER组127例，NER组39例，ER率为76.5%（127/166）。治疗后短期随访ER组清甲治疗前sTg（preablative sTg，ps-Tg）明显低于NER组［1.5（0.04-30.57）ng/mL vs 17.6（0.04-21.52）ng/mL；U=2 479，P<0.05］，且性别、年龄差异有统计学意义，男性及年龄稍小者更易出现NER。多因素分析显示，ps-Tg水平、肿瘤大小、淋巴结转移数目、性别、年龄及多灶性均为影响清甲疗效的相关因素（OR：0.361~2.875）。ROC曲线分析显示，ps-Tg最佳临界值为2.0 ng/mL。结论：ps-Tg水平较低、病灶较小、淋巴结转移数目较少、男性、年龄较小及单灶患者清甲治疗后短期内更易达到ER；且以ps-Tg值2.0 ng/mL为最佳临界点，对预测治疗后短期临床转归有较高的灵敏度和特异度。     

~(131)碘全身显像、甲状腺球蛋白测定及颈部超声检查在分化型甲状腺癌~(131)碘治疗随访中的意义

目的:探讨131I-全身显像(131I-WBS)、甲状腺球蛋白(Tg)测定及颈部B超检查在分化型甲状腺癌术后131I治疗随访中的意义.方法:31例分化型甲状腺癌术后131I治疗患者,治疗前后及随访中行甲状腺吸131I率、颈部B超、131I显像及甲状腺球蛋白测定.结果:治疗剂量131I-WBS较诊断剂量131I-WBS多发现3例转移灶;64人次Tg与131I-WBS检查结果:Tg与131I-WBS均阳性者19/64,均阴性者35/64,Tg阳性而131I-WBS阴性者5/64,Tg阴性而131I-WBS阳性者5/64;B超发现颈部淋巴结增大者为80.6%.结论:131I治疗分化型甲状腺癌转移灶效果突出,131I-WBS、Tg测定与颈部B超在其随访中联合应用可以相互补充,具有重要意义.     

224例分化型甲状腺癌放射性碘治疗分析

目的：对在我科8年来治疗的分化型甲状腺癌（DTC）患者进行回顾性分析,了解DTC发病规律,并证明131碘治疗DTC的疗效。方法：2002至2010年确诊为DTC并有颈部淋巴结转移的患者,进行甲状腺近全切除,并进行颈部淋巴结清扫,术后^131碘治疗。^131碘治疗后,每半年随访一次。随访指标：颈部超声检查;血清TSH、FT4、FT3;血清Tg、TgAb检查;全身放射性碘扫描;胸部CT或MRI。疗效判定：当血清Tg、TgAb阴性,颈部超声未见肿大淋巴结,全身放射性碘扫描未见放射性浓聚时,为DTC治愈。当上述指标为阳性时,则进行再次^131碘治疗。用SPSS软件进行统计学处理。结果：DTC患者数逐年明显增加;乳头癌与滤泡癌的比例约为12（207）：1（17）,女性患者远多于男性,男：女患者患病比例约为1（57）：3（167）;DTC在20-55岁之间为高发年龄段,峰值在25-35岁之间;^131碘治疗对DTC治愈率约达90%,近10%的顽固性DTC患者多次^131碘治疗效果欠佳。结论：分化型甲状腺癌患病率有明显增加趋势,25-35岁为高发年龄,女性多于男性,早期诊断及早期治疗是关键。手术切除甲状腺后进行^131碘治疗对DTC治愈率达90%。近10%的患者^131碘治疗效果欠佳,需寻求更好的治疗方法。     

^131I治疗老年分化型甲状腺癌肺转移的临床观察

目的观察^131I治疗老年分化型甲状腺癌（differentiated thyroid carcinoma,DTC）肺转移的疗效及不良反应。方法对31例老年DTC肺转移患者进行^131I治疗,并采用胸部CT、^131I显像及他变化综合判断疗效,并对可能影响^131I治疗DTC肺转移疗效的主要因素进行分析。结果^131I治疗的有效率为67．7％（21／31）;有无合并其他脏器远处转移（P=0．0059）及肺病灶类型（P=0.0271）为^131I治疗DTC肺转移疗效的主要影响因素;随访期内未出现由^131I治疗引起的肺纤维化、造血系统抑制、慢性涎腺炎和继发肿瘤。结论^131I治疗老年DTC肺转移有较好的疗效,不良反应低。     

Predictive value of thyroglobulin changes for the efficacy of thyroid remnant ablation.

The aim of this case-control study was to determine the utility of the evaluation of changes in serum thyroglobulin (Tg) levels before and after 1311 diagnostic total body scan (TBS) in patients with thyroid cancer to predict the efficacy of radioiodine ablation. Among 134 consecutive patients with differentiated thyroid carcinoma (DTC) who had undergone a thyroidectomy and TBS prior to radioiodine ablation, we selected those subjects with no evidence of distant metastases and with two consecutive assessments of Tg before TBS and radioiodine ablation within a period of four weeks. With this selection procedure 27 patients (22 with papillary and five with follicular carcinomas) were included in our evaluation. The ablation therapy was considered successful when the TBS performed one year after treatment did not show any or less than 1% cervical 131I uptake, Tg levels remained below 3 ng/mL, and clinical and instrumental examinations were negative for the presence of relapses. These criteria divided the selected patients into two subsets: patients with successful radioiodine ablation and patients with residual thyroid tissue. The majority of patients with unsuccessful ablation showed an increase in serum Tg levels, while most of the patients with successful ablation showed a steady decrease in Tg concentrations. Statistical analysis evidenced that the increase in Tg levels after TBS was related to unsuccessful ablation (P > or = 0.01). By contrast, the rate of thyroid remnants with 131I uptake did not show any relationship with the outcome of ablation therapy. The group of patients with increasing Tg levels after TBS had a relative risk of 3.3 of unsuccessful ablative therapy compared to the group with stable or decreasing Tg levels. This study supports the concept that by monitoring Tg levels in patients who undergo diagnostic TBS before radioiodine ablation it is possible to obtain useful information about the efficacy of 131I therapy.     

Importance of Postoperative Stimulated Thyroglobulin Level at the Time of 131I Ablation Therapy for Differentiated Thyroid Cancer

Background: Serum thyroglobulin detection plays an essential role during the follow-up of thyroid cancerpatients treated with total/near total thyroidectomy and radioiodine ablation. The aim of this retrospective studywas to evaluate the relationship between stimulated serum thyroglobulin (Tg) level at the time of high dose 131Iablation and risk of recurrence, using a three-level classification in patients with differentiated thyroid cancer(DTC) according to the ATA guidelines. Also we investigated the relationship between postoperative stimulatedTg at the time of ablation and DxWBS results at 8-10 months thereafter. Materials and Methods: Patientswith radioiodine accumulation were regarded as scan positive (scan+). If there was no relevant pathologicalradioiodine accumulation or minimal local accumulation in the thyroid bed region, this were regarded as scannegative (scan-) at the time of DxWBS. We classified patients in 3 groups as low, intermediate and high riskgroup for assessment of risk of recurrence according to the revised ATA guidelines. Also, we divided patients into3 groups based on the stimulated serum Tg levels at the time of 131I ablation therapy. Groups 1-3 consisted ofpatients who had Tg levels of ≤2 ng/ml, 2-10 ng/ml, and ≥10 ng/ml, respectively. Results: A total of 221 consecutivepatients were included. In the high risk group according to the ATA guideline, while 45.5% of demonstratedScan(+) Tg(+), 27.3% of patients demonstrated Scan(-) Tg(-); in the intermediate group, the figures were 2.3%and 90.0% while in the low risk group, they were 0.6% and 96.4%. In 9 of 11 patients with metastases (81.8%),stimulated serum Tg level at the time of radioiodine ablation therapy was over 10, however in 1 patient (9.1%)it was <2ng/mL and in one patient it was 2-10ng/mL (p=0.005). Aggressive subtypes of DTC were found in 8 of221 patients and serum Tg levels were ≤2ng/ml in 4 of these 8. Conclusions: We conclude that TSH-stimulatedserum thyroglobulin level at the time of ablation may not determine risk of recurrence. Therefore, DxWBSshould be performed at 8-12 months after ablation therapy.