Tg与TGA在分化型甲状腺癌术后监测及其疗效观察中的应用价值

目的：探讨甲状腺球蛋白（thyroglobulin,Tg）在分化型甲状腺癌（differentiated thyroid carcer,DTC）诊断及术后疗效观察中的应用价值。方法：采用放射免疫分析,对198例行甲状腺全切及次全切的DTC患者进行术后及术后半年血清Tg水平的追踪检测,同时行甲状腺球蛋白抗体（thyroglobulin antibody,TGA）的检测,并与正常对照组与转移组进行比较。结果：160例Tg〈20ng/ml的DTC患者阴性组术后1周血清Tg水平与对照组比较无明显差异（P〉0.05）;Tg水平〈10ng/ml者为56例,占35%。38例Tg〉20ng/ml阳性组术后1周时Tg水平明显高于阴性组和正常对照组（P〈0.01）。术后半年Tg水平随着病情好转逐渐下降,与术前1周之间呈明显正相关（t=4.951,P〈0.01）。23例远处转移癌的Tg水平明显高于颈部淋巴结转移组（P〈0.01）。术后Tg阴性患者其TGA增高者为25例,占20%。术后Tg阳性组TGA增高阳性率为42%。远处转移组TGA增高阳性率为56%。结论：Tg作为DTC的肿瘤标志物,在监测DTC手术效果、预后判断、复发、转移的诊断和鉴别治疗效果中具有重要的指导作用。

Applicative Value of Thyroglobulin and Thyroglobulin Antibody in Monitoring and Evaluating the Therapeutic Effect of Differentiated Thyroid Carcinoma Patients After Operation

Objective To discuss the clinical value of thyroglobulin(Tg) in the diagnosis of differentiated thyroid carcinoma and curative effect after surgical operation.Methods Detecting the serum Tg and TGA levels in 198 differentiated thyroid carcinoma(DTC) patients treated with surgical operation by RIA at after operation and six months later respectively,comparing with the group of normal controls and the metastasis group.Results There were no significant difference between the negative group of 160 DTC patients with Tg<20ng/ml and control group(P>0.05).In the negative group,there were 56 patients with Tg<10ng/ml,accounting for 35%.The Tg level in 38 patients of Tg>20ng/ml in the positive group was significant higher than negative group and normal control group one week after operation(P<0.01).The Tg declined as the condition of postoperative patients improved after six months,which was positive relationship with the result of one week before operation(t=4.951,P<0.01).The Tg level in the distance metastasis group was markedly higher than that in the neck lymph metastasis group(P<0.01).In the Tg negative group,there were 25 patients with increasing TGA,accounting for 20%.But in the Tg positive group the percentage with increasing TGA accounted for 42%,in the widespread metastasis group the percentage with increasing TGA accounted for 56%.Conclusion Tg as a tumor marker take the part in monitoring and evaluating surgical operation of differentiated thyroid carcinoma,might be utilized as an useful indicator of therapeutic effect as well as prognosis.