^(131)I显像联合Tg监测^(131)I治疗后甲状腺床残留患者的预后

^(131)I imaging combined with Tg monitoring the prognosis of DTC patients with residual thyroid tissue after initial ^(131)I treatment

目的:探讨分化型甲状腺癌(differentiated thyroid cancer,DTC)首次131I清甲治疗半年后甲状腺球蛋白(thyroglobulin,Tg)阴性但甲状腺床仍有少量残留的患者是否需要再次131I治疗。方法:甲状腺全切或近全切术后行131I治疗且TGAb正常者72例,按首次131I治疗后有无甲状腺床残留分为残留组27例,对照组45例,分别随访动态监测Tg、TGAb及131I显像。结果:残留组与对照组随访前后Tg均无显著变化;残留组(t=0.970,P>0.05),对照组(t=0.800,P>0.05)。首次随访残留组与对照组Tg无显著差别(t=0.43,P>0.05),随访末残留组与对照组Tg仍无明显差异(t=0.846,P>0.05)。结论:甲状腺全切或近全切除术后行131I治疗的分化型甲状腺癌患者,首次随访Tg<2μg/L但甲状腺床有少量残留时,无需再次碘治疗。

Objective： To investigate whether the patients of differentiated thyroid cancer after131I therapy for about six months,whose thyroglobulin was negative but still had a small residual thyroid tissue on the thyroid bed,need131I therapy again or not. Methods： 72 patients who underwent131I therapy after total or near total thyroidectomy and their TGAb values were all normal. After the initial131I therapy,patients were divided into residual group of 27 patients and control group of 45 patients according to whether the thyroid bed had residual thyroid tissue or not. All of them were followed up by dynamic monitoring of Tg,TGAb and131I imaging. Results： The Tg value of residual group and control group did not change significantly in first and last follow-up; observation group（ t =0. 970,P 0. 05）,control group（ t =0. 800,P 0. 05）. In the first follow-up,Tg value of observation group and control group has no significant difference（ t = 0. 43,P 0. 05）,at the end,observation group and control group has no noticeable difference ethier（ t = 0. 846,P 0. 05）. Conclusion： Patients of DTC underwent131I therapy after total or near total thyroidectomy,Tg 2 μg/L but still had a little residual thyroid tissue on the thyroid bed after131I therapy in the first follow-up,didn＇t need re-iodine therapy.