^(131)I治疗分化型甲状腺癌转移灶中甲状腺球蛋白测定和^(131)I-全身显像的意义

The value of thyroglobulin measured and ^(131)I-whole body scan on the differentiated thyroid carcinoma with ^(131)I

目的探讨分化型甲状腺癌转移灶治疗中131I-全身显像(131I-WBS)和甲状腺球蛋白(Tg)测定的意义。方法39例分化型甲状腺癌患者术后4～6周用131I行首次清除残余甲状腺治疗,3～6个月后重复治疗,治疗中131I-WBS和Tg测定同期完成。结果在首次清除残余甲状腺治疗时显像发现淋巴、肺及骨转移灶有11例,其余转移灶于重复治疗时发现。131I治疗分化型甲状腺癌转移灶,以淋巴转移效果最好,肺转移次之,骨转移最差。有8例患者(20.5%)Tg测定与131I-WBS不符。结论131I治疗分化型甲状腺癌转移灶效果好,患者存活率高;131I-WBS和Tg测定在分化型甲状腺癌随访中应联合应用,互相补充。

Objective To investigate the valve of ^131I - whole body scan （^131I-WBS） and thyroglobulin （Tg） on the differentiated thyroid carcinoma with ^131I, Methods The first ablation thyroid emnant at after thyroidectomy 4-6 weeks for all patients reseived ^131I 1,11 GBq, 1,85 GBq, 2.96 GBq, 3.7 GBq, respratery, The metestases patients retreatment was after 3-6 months, ^131I single doses rangging from 4.81-7.40 GBq. All patients were performed ^131I-WBS and measured serum Tg. Results 28 patients （71,8%） had successful ablation remnant tissue at first therapy, 11 patients have been found metastases in first thrapy, The effection of tretment were best for patients with lymph metastases, and the patients of lung metastases were better, there was no significant effect for patients with bone metastases, Tg measurements were 20.5% cases inconsistent with ^131I-WBS . Conclusions ^131I therapy is an effective methoud to treat the patients with differentiated thyroid carcinomatous metastases and enhance the patients＇ livability. The mensuration of ^131I- WBS and Tg should be combined operate to recruit reciprocally.