^(131)I和^(99m)Tc-MIBI全身显像联合血清Tg和CEA检测在分化型甲状腺癌^(131)I治疗随访中的应用

The Application of ^(131)I-and ^(99m)Tc-MIBI Whole Body Scan Combined Determination with Serum Thyroglobulin and CEA Levels in the Follow-up of Differentiated Thyroid Carcinoma with ^(131)I Radiotherapy

目的:评价131I-WBS和99mTc-MIBI全身显像联合血清Tg和CEA检测在分化型甲状腺癌术后放射性131I治疗随访中的应用价值。方法:48例DTC患者均行手术治疗并经131I治疗后(3～6)个月随访复查131I-WBS和血清Tg和CEA测定,131I-WBS显像阴性者于治疗后1年行99mTc-MIBI全身显像。结果:48例DTC患者行131I治疗后定期随访显示,35例患者的血清Tg水平及131I全身显象(131I-WBS)均为阴性,6例患者的血清Tg水平和131I-WBS均为阳性,两者符合率为85.42%(41/48);5例患者血清Tg水平为阳性而131I-WBS显像为阴性;2例患者血清Tg水平为阴性而131I-WBS显像为阳性。40例131I-WBS阴性者中99mTc-MIBI全身显像均为阴性。48例患者中仅2例血清CEA水平阳性。结论:131I-WBS显像联合血清Tg测定是检测甲状腺癌复发或转移最常用的方法,而99mTc-MIBI全身显像和血清CEA测定可作为131I-WBS和血清Tg测定有益的补充。

Objective To evaluate the value of 131I-and 99mTc-MIBI whole body scan combined determination with serum thyroglobulin and CEA levels in the follow-up of differentiated thyroid carcinoma with131I radiotherapy after surgical treatment.Methods Fourty eight patients with DTC after surgical treatment were treated with 131I radiotherapy.131I-whole body scan combined determination with serum thyroglobulin,CEA levels were performed three to six months after 131I radiotherapy.While 99mTc-MIBI whole body scan was performed one year after treatment when 131I-whole body scan was negative.Results Regular follow-up after 131I treatment in 48 patients showed that 35 cases were found negative with 131I-WBS and serum Tg level while 6 cases were proved positive in both methods,and 5 cases were negative in 131I-WBS with positive serumTg level,on the other hand,2 cases were positive in 131I-WBS with negative serum Tg level.40 cases of 131I-WBS negative patients in the 99mTc-MIBI whole body scintigraphy were also negative.In 48 patients only 2 cases had positive serum CEA level.Conclusion 131I-whole body scan combined with serum Tg level determination were the most commonly method in the detecting of a recurrent or metastatic thyroid cancer,and 99mTc-MIBI whole body scan and serum CEA level may become a useful supplement to 131I whole body scan and serum Tg level determination.