核素显像联合血清Tg检测在甲状腺癌治疗后随访中的价值  

The Follow-up Value of Combined Radionuclide Imaging with Detection of Serum Tg in Treatment of Differentiated Thyroid Cancer

作　　者：李伏燕[1] 吴立兵[1] 刘刚[1] 王卫民[1] 

机构地区：[1]湖北医药学院附属太和医院,湖北十堰442000

出　　处：《标记免疫分析与临床》2012年第6期348-350,共3页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨131I全身显像、甲状腺球蛋白检测、99Tcm-MIBI显像在分化型甲状腺癌(DTC)131I治疗后的随访价值。方法对260例DTC患者行甲状腺切除术并经131I清甲治疗后进行随访。DTC患者停用甲状腺素4周后检测甲状腺球蛋白(Tg),服用诊断剂量131I 185MBq(5mCi),于次日行131I全身显像(131I-WBS),分析Tg检测结果与131I-WBS的相关性;对Tg阳性而131I-WBS阴性的病人行99Tcm-MIBI显像,分析99Tcm-MIBI显像对于DTC患者的随访价值。结果 260例DTC患者中经过取样活检证实出现复发或转移者42例。其中Tg阳性患者40例,阴性2例,131I-WBS阳性患者36例,阴性患者6例;在40例Tg阳性患者中,131I-WBS阳性患者35例,其131I-WBS阳性检出率与复发或转移者的总阳性检出率没有统计学差异(P>0.05)。有5例Tg阳性而131I-WBS阴性的患者进一步做99Tcm-MIBI显像检查,有4例检出阳性病灶。结论 DTC患者清甲术后,Tg检测结果与131I-WBS结果有明显的相关性,无论何种检查出现异常,都提示体内存在肿瘤转移灶的可能性;当DTC患者清甲治疗后Tg阳性而131I-WBS阴性时,99Tcm-MIBI显像有助于转移灶的检出,是131I-WBS有益的补充。Objective To evaluate the follow-up value of 131I body imaging, detection of thyroid globulin （Tg） and 99Tern-MIBI imaging in differentiated thyroid cancer treatment. Methods Thyroideetomy and 131I clear treat- ment were performed on 260 cases of differentiated thyroid cancer （DTC） patients, and the treatment effects were then follow-up. The thyroid globulin （Tg） levels in DTC patients were detected after 4 weeks of thyroid hormone treatment. The 1311 whole body imaging （131I-WBS） was carried out next day after taking 185 MBq of diagnosis dose of 131I. The 99Tem-MIBI imaging was carried out in the patients who had Tg positive and 131I_WBS negative results, Results Total 42 eases were finally proven appeared the recurrence or metastasis in the 260 eases of DTC patients. Among them 40 cases had Tg positive, 36 eases had 1311_WBS positive. There were 35 eases had 131 I-WBS positive in the 40 cases patients with Tg positive. There was no significantly differ- ence between ~31I_WBS positive rate and recurrence or metastasis positive rate （P 〉 0.05）. 4 cases patients were detected to have positive lesions with 99Tme- MIBI imaging examination in 5 eases of patients with Tg posi- tive and 131 I-WBS negative results. Conclusion There is an obviously correlation between Tg detection test re- sults and 131I_WBS in differentiated thyroid cancer patients after 131I clear treatment. 99Tcm-MIBI imaging may be very helpful in detection of metastases lesions in patients with Tg positive and 1311-WBS negative results.

关 键 词：131I全身显像 甲状腺球蛋白 99TCM-MIBI显像 甲状腺癌随访 

分 类 号：R736.1[医药卫生—肿瘤]