DTC术后131I清甲治疗患者血清Tg及TgAb变化及其与病灶检出相关性分析

目的 探讨分化型甲状腺癌(DTC)患者在术后接受131I治疗后,血清甲状腺球蛋白(Tg)、甲状腺球蛋白抗体(TgAb)的变化及其与131I全身显像(Dx-WBS)结果的相关性,从而为DTC复发、转移的诊断提供依据.方法 入选我院DTC患者83例,均在行甲状腺全切或次全切手术4～6周后,给予131I治疗,半年后TSH刺激状态下(停用甲状腺素片并低碘饮食3周),检测血清Tg及TgAb,并对甲功各项指标进行复查,同时行131I全身显像检查.结果 TgAb阳性率随着Tg水平的变化而发生改变,对血清Tg的检出存在一定干扰性,将Tg与Dx-WBS二者联合进行判断,DTC复发及转移诊断准确率可达95％.结论 DTC术后131I清甲治疗半年后,Tg检测的准确性相对较高,但受TgAb干扰,存在假阴性,应与Dx-WBS进行联合作为DTC复发及转移的重要诊断指标.

Relationship Between Changes of Serum Tg,TgAb and the Detection of Differentiated Thyroid Carcinoma After Iodine-131 Treatment

Objective To investigate the relationship between changes of Tg,TgAb and the detection of differentiated thyroid carcinoma (DTC) by iodine-131 whole body scan (Dx-WBS) in the patients after thyroid ablation,and provide clinical evidence for judging recurrence and metastasis of DTC.Methods A total of 83 patients with DTC were collected retrospectively 6 months or more after 131I ablation therapy posttotal thyroidectomy or near-total thyroidectomy.Serum Tg and TgAb levels were measured,the thyroid function was checked and Dx-WBS was performed.Results The changes of TgAb were affected by Tg levels.When we combined Tg and Dx-WBS,The diagnosis accuracy rate for DTC recurrence and metastasis was as high as 95％.Conclusion Tg testing has the highest accuracy in screening on DTC patients after 6 months or more Iodine 131 treatment.But there might besome false negatives because of TgAb interference.Dx-WBS parallel testing is highly recommended in conjunction with Tg for the diagnosis in metastasis and recurrence of DTC.