Radioiodine total body scan versus serum thyroglobulin levels in follow-up of patients with thyroid cancer.
Radioiodine total body scan versus serum thyroglobulin levels in follow-up of patients with thyroid cancer.
复制标题
甲状腺癌患者随访中放射性碘全身扫描与血清甲状腺球蛋白水平的比较。
作者：
T. Colacchio;P. Logerfo;D. Colacchio;C. Feind
对两组患者进行了研究，以比较血清甲状腺球蛋白（Tg）水平与131 I全身扫描在甲状腺癌患者随访中的有效性。所有30例无复发患者在甲状腺激素替代治疗前后均检测不到Tg水平，尽管8例患者显示残留甲状腺组织摄取，但所有患者的全身扫描结果均为阴性。在第二组37例记录复发或转移性疾病的患者中，34例（92%）血清Tg水平阳性，尽管其中5例患者在甲状腺替代治疗时无法检测到Tg水平，31例（84%）全身扫描结果阳性。两种试验的假阴性结果不重叠，在Tg水平阳性的患者中，29例在甲状腺激素治疗停止后显示出显著增加。我们的结论是，虽然阳性Tg水平和身体扫描结果在复发性疾病的患者的百分比是相似的，这两种测试是必要的，以尽量减少未确诊的转移患者的数量。第二，促甲状腺激素抑制对甲状腺癌患者血清Tg水平有明确但不可预测的影响，应在测量血清Tg前停用甲状腺激素，以尽量减少假阴性结果的数量。
Two groups of patients were studied to compare the efficacy of serum thyroglobulin (Tg) levels to 131I total body scans in the follow-up of patients with thyroid cancer. All of the group of 30 patients without recurrence had undetectable Tg levels on and off thyroid hormone replacement, and all had negative total body scan results although eight patients showed uptake in remnant thyroid tissue. In the second group of 37 patients with documented recurrent or metastatic disease, 34 (92%) had positive serum Tg levels, although the levels in five of these patients were undetectable while on thyroid replacement, and 31 (84%) had positive total body scan results. The false negative results of the two tests were not overlapping, and of those with positive Tg levels, 29 showed a significant increase once thyroid hormone therapy had been withdrawn. We conclude that although the percentages of positive Tg levels and body scan results in patients with recurrent disease are similar, both tests are required to minimize the number of patients with undiagnosed metastases. Second, thyroid-stimulating hormone suppression has a definite although unpredictable effect on serum Tg levels in patients with thyroid cancer, and thyroid hormone should be withdrawn prior to measurement of serum Tg to minimize the number of false negative results.