分化型甲状腺癌患者^(131)I治疗后胸腺显影伴甲状腺球蛋白升高的临床分析  

Clinial analysis of radioactivity uptake in thymus combined with serum thyroglobulin increase in differentiated thyroid cancer patients after high-dose ^(131)I treatments

作　　者：黎颖昕 弓健[1] 郭斌[1] 尚靖杰[1] 程勇[1] 徐浩[1] 

机构地区：[1]暨南大学附属第一医院核医学科,广东广州510630

出　　处：《中国医学影像技术》2017年第7期985-988,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的分析分化型甲状腺癌(DTC)患者^(131)I清除术后残留甲状腺组织治疗后^(131)I全身扫描(^(131)I-WBS)胸腺异常碘摄取并伴甲状腺球蛋白(Tg)升高的发生率,探讨胸腺碘摄取及其对Tg升高的影响机制。方法回顾性分析316例接受^(131)I-WBS检查的DTC患者^(131)I-WBS影像及实验室检查资料,观察胸腺异常放射性碘摄取情况及血清Tg水平。结果316例患者共735例次^(131)I-WBS检查中,4例患者共5例次显像可见胸腺异常放射性碘摄取,占0.68%(5/735),均为治疗剂量全身扫描(Rx-WBS)条件下,且均为第2次^(131)I治疗后出现胸腺异常放射性碘摄取,其中1例患者在第3次^(131)I治疗后仍出现胸腺异常放射性碘摄取。3例患者共4例次Rx-WBS检查前血清Tg水平升高,分别为13.80μg/L、>300.00μg/L、16.40μg/L、20.60μg/L。结论 ^(131)I清除术后残留甲状腺组织治疗后Tg升高患者^(131)I-WBS仅上纵隔处出现异常摄取时,应注意排除胸腺原因所致可能,以避免不当治疗。Objective To investigate the incidence of radioactivity uptake in thymus combined with serum thyroglobulin （Tg） increase in differentiated thyroid cancer （DTC） patients after high-dose 131I treatments, in order to discuss the mechanism of thymus iodine uptaking and Tg increasing. Methods Retrospective analysis of the laboratory examinations and 131I-whole body scan （131I-WBS） images in 316 DTC patients were performed. The radioactivity uptake in thymus and the Tg level were observed. Results Among 316 patients （total 735 case-times）, 4 patients of 5 cases-times 131I-WBS showed radioactivity uptake in thymus, accounting for 0.68%（5/735）. All the radioactivity uptake in thymus were found by post-treatment 131I whole body scan （Rx-WBS） and after the second radioactive iodine treatment. For 1 of 4 patients, Rx-WBS still showed thymic uptake 131I after the third radioactive iodine treatment. The serum Tg increased in 3 patients （4 caes-times Rx-WBS） of radioactivity uptake in thymus with the Tg level before Rx-WBS was 13.80 μg/L, 〉300.00 μg/L, 16.40 μg/L, 20.60 μg/L, respectively. Conclusion In order to avoid the inappropriate administration of radioiodine therapy, thymic uptake should be identified carefully in DTC patients whose radioactivity uptake is only found at the upper mediastinal and combined with serum Tg increase.

关 键 词：甲状腺肿瘤 甲状腺球蛋白 胸腺 碘同位素 

分 类 号：R736.1[医药卫生—肿瘤] R817[医药卫生—临床医学]