血清Tg和TgAb水平监测在分化型甲状腺癌患者131I清甲治疗中的临床意义  

Clinical significance of the levels of serum Tg and TgAb in the ^(131)I ablation therapy for patients with differentiated thyroid cancer

作　　者：周琼[1] 陈森良[1] 罗淼 余书勇[2] ZHOU Qiong;CHEN Sen-liang;LUO Miao;YU Shu-yong(Department of Nuclear Medicine, 187th Central Hospital of PLA, Haikou 571159, China;Department of Surgical Oncology, 187th Central Hospital of PLA, Haikou 571159, China)

机构地区：[1]解放军第187中心医院核医学科,海口571159 [2]解放军第187中心医院肿瘤外科,海口571159

出　　处：《中国医学前沿杂志（电子版）》2017年第9期105-108,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨血清甲状腺球蛋白(thyroglobulin,Tg)和甲状腺球蛋白抗体(thyroglobulin antibody,Tg Ab)水平监测在分化型甲状腺癌(differentiated thyroid carcinoma,DTC)患者^(131)I清除甲状腺残余组织(简称清甲)治疗中的临床意义。方法选择2014年5月至2016年7月本院肿瘤外科确诊并有完整随访资料的DTC患者108例为研究对象,行^(131)I清甲治疗,于治疗前、治疗后6个月、治疗后12个月,采用放射免疫分析法检测患者血清Tg和TgAb水平,同时于治疗后第7天行^(131)I全身显像(^(131)I-whole body scan,^(131)I-WBS)。结果治疗后6个月和治疗后12个月,患者血清Tg、TgAb水平均明显低于治疗前(P<0.05);转移患者血清Tg、TgAb水平均明显高于未转移患者(P<0.05);治疗有效患者血清Tg、TgAb水平均低于治疗无效患者(P<0.05)。Tg+TgAb筛查阳性率与^(131)I-WBS筛查阳性率相近(P>0.05);Tg筛查阳性率和TgAb筛查阳性率均高于^(131)I-WBS筛查阳性率(P<0.05)。结论血清Tg、TgAb水平是评价DTC患者疗效、转移及复发的重要参考指标;Tg+TgAb筛查评价DTC患者转归,能避免Tg假阳性的误诊,具有较高的准确度。Objective To investigate the clinical significance of the serum levels of thyroglobulin(Tg)and thyroglobulin antibody(TgAb)in the131I ablation therapy for patients with differentiated thyroid cancer(DTC).Method108cases with DTC in our hospital of which follow-up data were completed were selected.The levels of serum Tg and TgAb were detected by radioimmunoassay before131I ablation therapy,6months and12months after131I ablation therapy.131I-whole body scan(131I-WBS)were used at the seventh days after131I ablation therapy.Result The levels of serum Tg and TgAb at6months and12months after therapy were significantly lower than those before therapy(P<0.05).The levels of serum Tg and TgAb in metastasis group were higher than that in non-metastasis group(P<0.05).The serum levels of serum Tg and TgAb in effective group were lower than those in ineffective group(P<0.05).The positive rate of Tg combined with TgAb was similar with131I-WBS screening methods(P>0.05).The positive rate of Tg screening method and the positive rate of TgAb were higher than that of131I-WBS screening method(P<0.05).Conclusion The levels of serum Tg and TgAb are important reference indexes for the efficacy,metastasis and recurrence of DTC after operation,and Tg combined with TgAb has a higher accuracy in the screening prognosis of DTC after therapy.

关 键 词：分化型甲状腺癌 甲状腺球蛋白 甲状腺球蛋白抗体 131I清甲治疗 

分 类 号：R736.1[医药卫生—肿瘤]