分化型甲状腺癌^(99)Tc^m-MIBI显像与术后刺激状态甲状腺球蛋白水平的关系  

Correlation Between^(99)Tc^m-MIBI Imaging and the Level of Stimulating Tg After Operation in Differentiated Thyroid Carcinoma

作　　者：龙再颖 汤春静[1] 马端兰 于立明[1] 赵燕霞[1] 赵旭龙[1] 

机构地区：[1]威海市立医院核医学科,山东威海264200

出　　处：《中国医学影像学杂志》2012年第5期386-388,392,共4页Chinese Journal of Medical Imaging

摘　　要：目的探讨分化型甲状腺癌(DTC)99Tcm-甲氧基异丁基异腈(MIBI)显像与术后刺激状态下甲状腺球蛋白(Tg)水平的关系。资料与方法经手术和病理确诊的69例DTC患者行甲状腺全切或近全切除术,45例同时行颈部淋巴结清扫术,术前行99Tcm-MIBI早期及延迟显像,计算早期及延迟显像肿瘤/正常组织放射性(T/N)比值及洗脱率,检测术前及术后刺激状态Tg水平,以术后刺激状态Tg水平差异分为阳性组和阴性组。结果 Tg阳性组早期、延迟显像T/N比值较Tg阴性组低,洗脱率较Tg阴性组高,差异有统计学意义(t=2.821、3.211、6.412,P<0.01);Tg阳性组与Tg阴性组术前Tg水平差异无统计学意义(P>0.05),Tg阳性组术后刺激状态Tg水平较Tg阴性组高,差异有统计学意义(t=4.167,P<0.01)。31例(350枚)切除的淋巴结为DTC转移。术后刺激状态Tg水平与99Tcm-MIBI洗脱率(r=0.625,P<0.01)及颈部淋巴结转移数目(r=0.676,P<0.01)呈正相关。结论 DTC99Tcm-MIBI早期、延迟显像T/N比值及洗脱率与术后刺激状态Tg水平及颈部淋巴结转移密切相关。Purpose To discuss the relationship between 99Tcm-methoxy isobutyl isonitrile（MIBI） imaging and postoperative stimulating thyroglobulin（Tg） in differentiated thyroid carcinoma（DTC）.Materials and Methods Sixty-nine patients with DTC confirmed by histopathology underwent thyoidoectomy and subtotal thyoidoectomy,45 patients underwent radical cervical lymphadenectomy,early and delayed imaging with 99Tcm-MIBI were done before surgery.The T/N ratio of early and delayed imaging in tumor over normal tissue was calculated,the preoperative and postoperative stimulating Tg were measured.These 69 patients were divided into Tg positive group and Tg negative group according to postoperative Tg level.Results The T/N ratio of early and delayed imaging in Tg positive group was statistically lower than that in Tg negative group,and the clearance rate was statistically higher than that in Tg negative group（t=2.821,3.211,6.412,P 0.01）.No statistical difference in preoperative Tg level was observed between the two groups（P 0.05）.Postoperative stimulating Tg level of Tg positive group was statistically higher than that of Tg negative group（t = 4.167,P0.01）.350 lymph node in 31 cases were confirmed metastases from DTC.Postoperative stimulating Tg level was positively correlated with clearance rate of 99Tcm-MIBI（r = 0.625,P 0.01） and the number of metastatic cervical lymph node（r=0.676,P 0.01）.Conclusion The T/N ratio and clearance rate of early and delayed 99Tcm-MIBI imaging are closely related to postoperative stimulating Tg level and metastatic cervical lymph node.

关 键 词：甲状腺肿瘤 甲状腺球蛋白 99M锝甲氧基异丁基异腈 

分 类 号：R736.1[医药卫生—肿瘤] R445.5[医药卫生—临床医学]