甲状腺球蛋白测定和131I-全身显像在综合治疗分化型甲状腺癌随访中的价值

目的:探讨血清甲状腺球蛋白(Tg)和131I-全身显像(131I-WBS)联合检查在分化型甲状腺癌(differentiatedthyroidcarcinoma,DTC)患者手术+131I治疗后随访中的临床价值。方法:55例DTC患者术后3～4周行131I清除残余甲状腺组织治疗(以下简称"清甲"),131I治疗前及随访时用RIA法各测定1次血清Tg,同时口服131I111～185MBq(平均133.8MBq)48h后,和(或)口服治疗剂量131I3.7～5.55GBq(平均4.5GBq)5～7d后做全身显像。结果:24例经临床证实有复发或转移的DTC患者中,11例(45.8%)Tg>10ng/mL,21例(87.5%)131I-WBS阳性,只有8例(33.3%)患者Tg和131I-WBS同时阳性。结论:DTC经手术+131I治疗后,常规进行Tg测定和131I-WBS检查,对尽早发现复发或有无转移、决策131I治疗方案以及评估131I疗效具有重要的临床价值。

The clinical value of serum thyroglobulin combined with Iodine-131 whole body scanning in the follow-up of differentiated thyroid cancer after thyroid ablation

Objective To investigate the clinical value of serum thyroglobulin(Tg) measurements combined with Iodine-131 (131I) whole body scans (WBS) in the follow-up of differentiated thyroid carcinoma (DTC) after thyroid ablation.Methods Fifty-five patients were enrolled in the study.A diagnostic 131I-WBS was performed 48h after administration of 111 ～ 185 MBq 131I in patients with post-thyroidectomy and 131I ablated treatment.Subsequently,therapeutic 131I-WBS were performed 5 ～ 7 days after administration of 3.7 ～ 5.55 GBq 131I.Serum Tg and anti-thyroglobulin autoantibody were measured in all patients.Results In 11 of 24 patients (45.8%) with relapsed or metastatic differentiated thyroid carcinoma,the serum Tg values increased over normal range.In 21 patients (87.5%),the results of 131I-WBS were positive.Among these patients,both abnormally radioactive uptake in 131I-WBS and elevation of serum Tg were found in only 8 patients (33.3%).Conclusions Routine serum Tg measurement and 131I-WBS in patients with DTC after thyroidectomy is essential.It is of great clinical value in early detecting metastatic nidus,optimizing the treatment protocol and evaluating the curative effect.