分化型甲状腺癌甲状腺清除术后血清Tg与^(131)I-全身显像的关系

CORRELATION OF SERUM THYROGLOBULIN WITH ^(131)I-WBS IN PATIENTS WITH DIFFERENTIATED THYROID CARCINOMA AFTER RADICAL THYROIDECTOMY

目的探讨分化型甲状腺癌(DTC)甲状腺清除术后血清甲状腺球蛋白(Tg)与131I-全身显像(131I-WBS)之间的关系,为临床随访和治疗分化型甲状腺癌提供一定的依据。方法检测83例DTC病人甲状腺清除术后血清Tg水平,在给予5.55 GBq131I治疗5~7 d后行131I-全身显像,对131I-全身显像所示肿瘤转移灶的数量和范围行半定量法评分,用斯皮尔曼相关性分析评价血清Tg与131I-全身显像评分之间的关系,同时比较不同病理类型DTC血清Tg与131I-全身显像评分之间关系的差异。结果87.95%(73/83)的DTC病人甲状腺清除术后血清Tg水平和131I-WBS显像符合,9.64%(8/83)的DTC病人血清Tg阳性(Tg>0.10μg/L)而131I-WBS阴性,有2.41%(2/83)的DTC病人血清Tg阴性而131I-WBS阳性(肿瘤转移灶浓聚131I)。DTC甲状腺清除术后血清Tg水平与131I-全身显像评分呈高度正相关(r=0.725~0.849,P<0.01),不同病理类型的DTC血清Tg水平与131I-全身显像评分之间相关性差异无统计学意义(P>0.05)。结论DTC甲状腺清除术后血清Tg水平与131I-全身显像有相关性,Tg水平升高预示DTC病人体内存有大量肿瘤转移灶,应对其密切随访并给予适当治疗。

Objective To investigate the correlation between the levels of serum thyroglobulin （Tg） and ^131I whole body scan （^131I- WBS） in patients with differentiated thyroid carcinoma （DTC） after radical resection, in order to provide a clinical evi dence for follow-up and therapy of the disease. Methods Levels of serum Tg were measured in 83 patients with DTC before ra dioactive iodine therapy. ^131I- WBS was offered after administration of 5.55 GBq radioactive iodine for .5- 7 days. Serniquantitative visual analysis was used to grade the extent of metastasis showed in 1311 WBS, and Spearman＇s rank correlation to analyze the cor relation between levels of serum Tg and score of ^131I- LWBS. The correlation between serum Tg and score of ^131I- WBS in different types of pathology of DTC was analyzed as well. Results Of the 83 patients, 87.95% （73/83） of their serum Tg levels were in line with scores of ^131I- WBS, 9. 64% （8/83） of them showed positive serum Tg （Tg〉0. 10 μg/L） and negative 1311 WBS, and 2.41% （2/88） had negative serum Tg and positive ^131I-WI3S.The correlation between serum Tg levels and extent of metastasis in patients with DTC was significant （r=0. 725 0. 849, P〈0. 01）, while correlation between serum Tg levels and scores of ^131I- WBS in different types of pathology of DTC was not （P〉0.05）. Conclusion Serum levels of Tg are correlated with ^131I-WBS, raising level of serum Tg signifies massive metastasis in DTC patients, a close follow up and proper treatment are suggested.