| 李飞,邓庆梅,黄山.血清刺激性甲状腺球蛋白水平监测诊断分化型甲状腺癌转移的意义[J].中华放射医学与防护杂志,2018,38(9):660-663 |
| 血清刺激性甲状腺球蛋白水平监测诊断分化型甲状腺癌转移的意义 |
| The significance of serum stimulating thyrogloblin level in monitoring and diagnosis of differeniated thyroid carcinoma metastasis |
| 投稿时间：2018-03-28 |
| DOI：10.3760/cma.j.issn.0254-5098.2018.09.004 |
| 中文关键词: 分化型甲状腺癌 甲状腺球蛋白 术后刺激性甲状腺球蛋白 血清刺激性甲状腺球蛋白 131I治疗 |
| 英文关键词:Differentiated thyroid carcinoma Thyroglobulin Thyroid stimulatory globulin Thyroglobulin antibody 131I treatment |
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| 中文摘要: |
| 目的 探讨刺激性甲状腺球蛋白（ps-Tg）水平监测在诊断分化型甲状腺癌（DTC）转移的临床意义。方法 选择2009年3月至2018年3月治疗DTC患者73例，依据131I显像，分为3组：无转移组，32例；淋巴结转移组，31例；远处转移组，每组10例。分别检测术后131I清甲治疗前及131I清灶治疗前1周内血清刺激性甲状腺球蛋白（ps-Tg，s-Tg）水平，131I治疗后第3~5天行131I全身显像（131I-WBS），病例随访时间8~12个月。结果 无转移组与淋巴结转移组中ps-Tg差异无统计学意义（P>0.05），都显著低于远处转移组（Z=-3.81、-3.371，P<0.05）；首次131I清灶治疗前s-Tg在无转移组与淋巴结转移组和远处转移组差异有统计学意义（H=11.764，P<0.05）。131I清甲治疗前ps-Tg诊断DTC远处转移ROC曲线下面积（AUC）为0.903，准确度为90.48%；s-Tg诊断DTC远处转移和淋巴结转移AUC分别为0.817和0.644，准确度为88.10%和65.08%。结论 术后131I清甲治疗前ps-Tg诊断DTC远处转移准确度优于131I清灶治疗前s-Tg，131I清灶治疗前s-Tg水平诊断DTC淋巴结优于131I清甲治疗前ps-Tg。 |
| 英文摘要: |
| Objective To investigate the clinical significance of postoperative stimulated thyroglobulin (ps-Tg) detection in the patients with differentiated thyroid carcinoma (DTC) 131I therapy. Methods Totally 73 cases with DTC who were hospitalized from March 2009 to March 2018 with complete treatment and follow-up data were selected as the study subjects. The cases were divided into three groups by 131I scanning image, no metastasis group (32 cases), lymph node metastasis group (31 cases), and distance metastasis group (10 cases). The levels of stimulated thyroglobulin (s-Tg) in serum were detected within one week before 131I ablation for thyroid remnant and metastasis after surgical treatment. The 131I-whole body scan (131I-WBS) was performed at 3 to 5 days after 131I treatment and these cases were followed-up for 8-12 months. Results There was not statistically significant difference in ps-Tg between no metastasis group and lymph node metastasis group before 131I treatment(P>0.05). The ps-Tg in distance metastasis group was significantly higher than that in patients without metastasis and lymph node metastasis(Z=-3.810、Z=-3.371, P<0.05). Before treatment with 131I ablation metastasis, there was not statistically difference in s-Tg among 3 groups(H=11.764, P<0.05). The area under the ROC curve of ps-Tg and s-TG diagnostic DTC distant metastasis rate before treatment of ablation for thyroid remnant was 0.903, and the accuracy were 90.48%. The area under the ROC curve of diagnosis of DTC distant metastasis and lymph node metastasis before ablation for thyroid metastasis was 0.817 and 0.644, and the accuracy was 88.10% and 65.08%, respectively. Conclusions The accuracy of diagnosing DTC distant metastasis of ps-Tg before 131I ablation for thyroid remnant is superior to ps-Tg before ablation for thyroid metastasis. The level of s-Tg diagnosis of DTC lymph node before 131I ablation metastasis precede ps-Tg before 131I ablation for thyroid remnant |
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