分化型甲状腺癌清甲治疗后^(131)I全身显像与甲状腺球蛋白检测结果的相关性分析

Analysis on correlation of thyroglobulin with 131-iodine whole body scan in differentiated thyroid carcinoma patients after thyroid ablation

目的:评价分化型甲状腺癌(DTC)患者清甲治疗后131I全身显像(131I-WBS)与甲状腺球蛋白(Tg)检测结果的相关性,为判定甲状腺癌的复发及转移提供参考指标。方法:596例DTC患者,均行甲状腺部分切除术及131I清甲治疗,术后常规服用甲状腺激素进行替代治疗。首先检测血清中Tg水平,然后给予患者诊断剂量131I(185MBq),分别于服药后24、48及72h进行全身显像,对131I-WBS中异常浓聚灶的范围及数量进行半定量法评分,分析Tg检测结果与131I-WBS评分的相关性。结果:596例患者中,最后经过证实出现复发或者转移者64例。64例患者中,Tg检测升高患者63例,正常1例;131I-WBS阳性患者56例,阴性患者8例。63例Tg升高患者中,55例131I-WBS亦为阳性;56例131I-WBS阳性患者中,55例Tg检测亦升高,无1例患者2项检查均为阴性。Tg检测结果与131I-WBS评分结果正相关(r=0.718～0.812,P<0.01)。结论:DTC清甲术后,Tg检测结果与131I-WBS结果有明显的相关性,无论何种检查出现异常,都提示体内存在肿瘤转移灶,应给予密切观察并适当治疗。

Objective To evaluate the correlation of thyroglobulin（Tg） with 131-iodine whole body scan（131I-WBS） in the differentiated thyroid carcinoma（DTC） patients after thyroid ablation and provide reference index for judging recurrence and metastasis of DTC.Methods 596 patients with DTC were cut off partial thyroid and then undergone remanent thyroid ablation with 131I and took thyroid hormone regularly.The serum Tg levels were measured and 131I-WBS was offered after administration of 185 MBq radioactive iodine for 24,48 and 72 h.Semiquantitative visual analysis was used to grade the extent of metastasis showed in 131I-WBS.The correlation of Tg levels with 131I-WBS scores was analyzed.Results In 596 DTC patients,64 cases were confirmed with recurrence and metastasis.In these patients,the results of Tg were positive in 63 cases and negative in 1 case;the results of 131I-WBS were positive in 56 cases and negative in 8 cases.In 63 cases with positive Tg,131I-WBS were also positive in 55 cases.In 56 cases of patients with positive131I-WBS,the levels of Tg in 55 cases were also positive.Nobody was both negative in two checks.The serum Tg levels had positive correlation with 131I-WBS scores（r=0.718-0.812,P〈0.01）.Conclusion The serum levels of Tg are correlated with 131I-WBS after thyroid ablation,the raising of serum Tg level indicates massive metastasis in DTC patients,a close follow-up and proper treatment are suggested.