甲状腺球蛋白在分化型甲状腺癌诊治中的作用

Value of Serum Thyroglobulin in Diagnosis and Treatment of Differentiated Thyroid Cancer Patients

目的探讨甲状腺球蛋白(thyroglobulin,TG)在分化型甲状腺癌(differentiatedthyroidcancer,DTC)诊断和治疗中的作用。方法采用文献回顾的方法,对血清TG的检测方法及其在DTC诊断和术后随诊中的作用进行综述。结果免疫测定法(immunometricassay,IMA)是临床常用的检测方法,检测TG的同时应检测甲状腺球蛋白抗体(TG Ab)是否存在。手术前的TG水平对于诊断DTC的帮助不大,但对于区分DTC中不同病理类型有一定的帮助。在行甲状腺全切除或近全切除+131I去除残留腺体治疗后的患者中,血清TG是随诊中非常重要的检测指标。检测停用甲状腺激素或在人重组TSH(recombinanthumanthyrotropin,rhTSH)刺激下的TG水平更能准确反映疾病情况。结论TG在甲状腺全切除或近全切除+131I去除残留腺体治疗后患者的随诊中有很重要的作用。

Objective To discuss the value of thyroglobulin （TG） in diagnosis and treatment of differentiated thyroid cancer （DTC） patients. Methods Literatures on measurement and clinical application of serum TG were reviewed. Results Immunometric assay （IMA） was adopted by most clinical lab. TG antibody （TG-Ab） should be measured in the same sample of DTC patient. TG detection before operation is of less value in confirming diagnosis of DTC, but is helpful in differential diagnosis of histopathological type of DTC. TG detection after operation is very important in patients who had undergone total thyroidectomy. Monitoring TG after thyroid hormone withdrawal or recombinant human TSH stimulation is more sensitive to identify tumor recurrence. Conclusion Monitoring TG after total thyroidectomy has great value in follow-up of DTC patients.