ASSESSMENT OF THYROXINE SUPPRESSION IN THYROID CARCINOMA PATIENTS WITH A SENSITIVE IMMUNORADIOMETRIC TSH ASSAY
ASSESSMENT OF THYROXINE SUPPRESSION IN THYROID CARCINOMA PATIENTS WITH A SENSITIVE IMMUNORADIOMETRIC TSH ASSAY
复制标题
使用敏感的免疫放射测定促甲状腺激素测定法评估甲状腺癌患者的甲状腺素抑制
DOI：
10.1111/j.1365-2265.1986.tb01690.x
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发表时间：
1986
影响因子：
3.2
通讯作者：
K. Liewendahl
中科院分区：
文献类型：
--
作者：
B. Lamberg;T. Helenius;K. Liewendahl
用放射免疫法（TSH IRMA）测定了57例分化型甲状腺癌术后T_4抑制治疗患者的血清TSH。当使用常规RIA技术时，基础TSH不可检测，并且即使在用TRH刺激后仍如此。使用TSH IRMA方法，46名患者的基础TSH低于检测限（0.02 mU/l）（81%），7名患者的值在0.02和0.05 mU/l之间（12%）。其中23例有0.01 - 0.15 mU/l的小幅增加。2例患者的基础TSH为0.08和0.09 mU/l，TRH后的增量小于0.7 mU/l。在另外两名基础值接近0.2 mU/l的患者中，TRH后的增量超过1.0 mU/l。一个不可检测的基础TSH值并没有因此预测没有反应TRH。然而，除两例外，所有病例的反应都很小，可以认为在临床上无意义。因此，作者得出结论，使用TSH IRMA方法（检测限为0.05）测量的基础TSH为0.1 mU/l，足以表明接受T4治疗的癌症患者的TSH抑制，无需进一步进行TRH刺激试验。
Serum TSH was determined with a sensitive radioimmunometric method (TSH IRMA) in 57 patients on suppression therapy with T4 after operation for differentiated thyroid carcinoma. When using a conventional RIA technique basal TSH was not detectable and remained so even after stimulation with TRH. With the TSH IRMA method 46 patients had a basal TSH below the detection limit (0·02 mU/l) (81 %) and in seven patients the values were between 0·02 and 0·05 mU/l (12%). In 23 of these patients there was a small increment of 0·01–0·15 mU/l. In two patients the basal TSH was 0·08 and 0·09 mU/l, and the increment after TRH was less than 0·7 mU/l. In two other patients with basal values close to 0·2 mU/l the increment after TRH was more than 1·0 mU/l. An undetectable basal TSH value did not thus predict an absent response to TRH. The responses were, however, in all but two cases, so small that they could be regarded as clinically insignificant. Therefore, the authors conclude that a basal TSH of 0·1 mU/l, as measured with a TSH IRMA method with a detection limit of 0·05, is a sufficient indication of TSH suppression in carcinoma patients on T4 therapy and that further testing with the TRH‐stimulation test is unnecessary.