血清HTg测定与^(131)I全身显像在分化型甲状腺癌患者^(131)I治疗随访中的临床价值  

Comparison of the Clinical Usefulness of Serum Thyroglobulin(HTg) Determination and ^(131)I Whole Body Scan for Follow-up of Differentiated Thyroid Cancer

作　　者：王辉[1] 付宏亮[1] 吴真[1] 李佳宁[1] 杜学亮[1] 邹仁健[1] 吴靖川[1] 

机构地区：[1]上海交通大学医学院附属新华医院核医学科,200092

出　　处：《放射免疫学杂志》2007年第1期5-7,共3页Journal of Radioimmanology

摘　　要：目的:对比研究血清HTg的变化与131I全身显像在分化型甲状腺癌131I治疗随访的临床价值。方法:192例分化型甲癌患者,每位患者均为手术后接受(3~7)次的131I治疗,每次剂量(50~250)mCi,每次治疗前测定血清HTg,治疗后5d后进行前、后位全身显像。结果:192例接受131I去除术后残留甲状腺组织患者,HTg测试和131I全身显像人次各为825次。其中有125例患者HTg与131I全身显像均异常,有12例131I全身显像异常而HTg正常;有35例131I全身显像正常而HTg异常;有20例两者均正常。在47例结果不一致的患者中,其他影像证实12例131I全身显像异常患者有5例异常,而35例131I全身显像正常而HTg异常患者,有27例异常。结果显示HTg血清测定诊断分化型甲状腺癌转移的灵敏度和特异性分别为83%和97%,而131I全身显像的诊断灵敏度和特异性分别为72%和83%。结论:在分化型甲状腺癌131I治疗随访中,血清HTg的检测较131I全身显像更易发现甲状腺癌转移病灶,故前者有利于分化型甲癌患者随访及诊疗计划的安排。Objective To compare the clinical usefulness of serum thyroglobulin （HTg） determination with that of ^131Ⅰ whole body scan for follow - up of differentiated thyroid cancer. Methods There were altogether 192 patients with differentiated thyroid cancer receiving post - operative ^131Ⅰ therapy for 3 - 7 times at the dose of 50 - 250mCi. Serum HTg levels were measured with HTg each time before ^131Ⅰ treatment and whole body scans were performed 5days after treatment. Results Among the 192 cases, serum HTg and body scan were both abnormal in 125 patients. In 12 patients, HTg levels were normal but body scans demonstrated abnormal- ities. On the other hand, 35 patients with normal scans had elevated HTg levels. Both examinations were negative in 20 patients. In the 35 patients with abnormal HTg levels only, image study with means other than ^131Ⅰ （ F - 18 FDG SPECT, ultrasonics ） revealed lesions in 27 patients. Taking results from other image studies as standard （ CT, MRT, x - ray）, the sensitivily of HTg positiveness and ^131Ⅰ scan positiveness were 85% and 72% respectively and the specificity 97%, 83% respectively. Conclusion Result from this study suggested that it would be able to discover more metastatic or recurrent lesions with serum HTg determination in the follow - up of patients with differentiated thyroid cancer.

关 键 词：甲状腺癌 血清甲状腺球蛋白 ^131Ⅰ全身显像 

分 类 号：R736.1[医药卫生—肿瘤]