甲状腺癌^(131)I清甲治疗前后Tg及TgAb测定值分析

The Effects of Thyroglobulin and Thyroglobulin Antibody on Thyroid Carcinoma with ^(131)I Thyroid Ablation

[目的]分析甲状腺癌^(131)I清甲治疗后随访中甲状腺球蛋白(Tg)及甲状腺球蛋白抗体(TgAb)变化的意义。[方法 ]回顾性80例甲状腺癌患者,行甲状腺全切术或次全切术加淋巴结清扫术后实施^(131)I清甲治疗前1d和治疗后7d及治疗后半年Tg和TgAb水平变化情况。[结果 ]术前Tg阳性组37例患者治疗前1d和治疗后7d的Tg和TgAb水平明显高于^(131)I清甲治疗半年后和对照组的Tg和TgAb水平,而治疗后半年的Tg和TgAb水平与对照组比较差异无统计学意义(P>0.05)。术前Tg阴性组43例患者治疗前1d和治疗后7d的Tg和TgAb水平明显高于^(131)I清甲治疗半年后和对照组的Tg和TgAb水平,而清甲治疗后半年的Tg和TgAb水平与对照组比较差异无统计学意义(P>0.05)。阳性组治疗后有30例患者Tg水平转阴,转阴率81.08%。Tg水平和TgAb水平间无明显相关性(r=-0.068,P>0.05)。术前阳性组缓解率(81.08%)低于阴性组(90.70%),但差异无统计学意义(χ~2=0.115,P=0.735)。[结论 ]甲状腺癌患者Tg水平和TgAb水平随着治疗后时间的延长下降趋势越明显。^(131)I清甲治疗后加强对Tg和TgAb水平的监测对判断预后具有重要作用。

[Objective] To evaluate the effects of thyroglobulin（Tg） and thyroglobulin antibody（Tg-Ab） on thyroid carcinoma with ^131I thyroid ablation. [Methods] The Tg and TgAb levels in 80 patients underwent total thyroidectomy or subtotal thyroidectomy and lymph node dissection 1d before treatment and 7d after treatment with ^131I thyroid ablation were retrospectively analyzed.[Results] The Tg and TgAb levels in patients 1d before treatment and 7d after treatment with ^131I thyroid ablation were significantly higher than those in patients six months after treatment with ^131I thyroid ablation and the healthy controls both in the positive and negative Tg and TgAb patients（P〈0.05）. However,statistical significance was not found between patients six months after treatment and the healthy controls（P〉0.05）. There were 30 cases in patients positive with Tg become negative,The negative rate was 81.08%. No correlation was observed between the Tg and TgAb levels（r=-0.068,P〉0.05）. Moreover,the results showed that the response rate in patients positive with Tg were significant lower than that in patients negative with Tg,with 70.27% and 90.70%,respectively. [Conclusions] The serum Tg and Tg-Ab levels are lower with the more significant treatment effect,and the abnormal serum Tg and Tg-Ab levels indicated that the deterioration of patient＇s physical condition. Therefore,strengthening continuous measure of serum Tg and Tg-Ab levels could process important value to judge the prognosis of thyroid carcinoma after ^131I treatment.