Tg联合^(131)I全身显像在DTC术后^(131)I清甲成功后随访的意义

THE VALUE OF THYROGLOBULIN MEASUREMENT AND ^(131)I WHOLE BODY SCAN ON THE DIFFERENTIATED THYROID CARCINOMA WITH ^(131)I THERAPY AFTER SURGICAL TREATMENT

目的探讨分化型甲状腺癌(differentiated thyroid cancer;DTC)患者术后经131I成功清除残余甲状腺组织(清甲)后随访中,血清甲状腺球蛋白(thyroglobulin,Tg)的测定和131I全身显像(131I-whole body scan;131I-WBS)联合应用的意义。方法 37例均为DTC术后、给与131I 3700MBq-4440MBq首次清除其术后残留的甲状腺组织并获得清甲成功的患者,清甲成功后6个月进行随访,测定血清Tg、行131I-WBS。结果不同血清Tg水平组间,DTC复发或转移的发生率随Tg水平升高而显著增加,组间比较差异有统计学意义(P<0.05)。本研究中Tg测定阴性而131I-WBS提示双肺和(或)淋巴转移的6例,经131I-WBS扫描显示阴性Tg值测定为阳性的2例。结论血清Tg测定和131I-WBS可作为DTC患者清甲后有无复发、转移的重要指标,二者在随访中应联合应用,可互相补充。

Objective To investigate the value of thyroglobulin（Tg）and 131 I whole body scan（131I WBS）on the meaning of measured serum treatment recur or transfer with differentia tedthyroid carcinoma（DTC）after 131 I therapy.Methods 37 patients with DTC after surgical treatm-ent were treated with 131 I therapy,The serum Tg levels in patients were measured,and all patients were also performed 131 I WBS.Results The serum Tg levels in 2patients.patients were abnormal,but131 I WBS was negative.6patients have been found metastases to lymph,lung and bone in first 131 I therapy.The serum Tg levels in 6patients were normal,but the131 I WBS results were positive.Serum level between different Tg group,The incidence of recurrence or DTC transfer with Tg levels rise and increased significantly,Comparing between groups with a statistical significance（P 0.05）.Conclusion The combined measurement of serum Tg level and 131 I WBS could be regarded as important index in the diagnosis of metastases of cancer on the patients with differentiated thy-roid carcinoma.