HTg测定和^(131)I全身显像检查对甲状腺癌^(131)I治疗后随访的临床意义  

Significance of Iodine-131 whole body scanning combined with serum thyroglobulin in the follow-up of differentiated thyroid cancer after thyroid ablation

作　　者：李劲松[1] 吴靖川[1] 傅宏亮[1] 李佳宁[1] 杜学亮[1] 顾振辉[1] 施海虹[1] 吴真[1] 

机构地区：[1]上海第二医科大学附属新华医院核医学科,上海200092

出　　处：《肿瘤防治杂志》2004年第1期84-86,共3页China Journal of Cancer Prevention and Treatment

摘　　要：目的 :评价血清HTg和 13 1I全身显像联合检查对分化型甲状腺癌 (differentiat edthyvoidcarcinoma ,DTC)患者 13 1I治疗后随访的临床意义。方法 :85例DTC患者停服甲状腺激素 4～ 6周并忌碘饮食 3 0d后 ,双抗体法测定血清HTg ,同时口服 13 1I 185～3 70MBq 2 4h后 ,和 (或 )口服治疗剂量 13 1I 4～ 7d后做全身显像。结果 :61例经临床证实有复发或转移的DTC患者中 ,3 8例(62 3 0 % )HTg高于正常 ,有肺或 (和 )骨转移者 ,血清HTg升高更加明显 ,极端甚至 >2 0 0 μg/L。2 2例肺转移及肺 (骨 )转移患者 ,其血清HTg水平随 13 1I治疗剂量的增加而呈降低趋势。 5 3例 (86 88% ) 13 1I全身显像结果和 (或 )血清HTg有阳性表现 ,只有49 18% (3 0 /61)的患者同时出现 13 1I全身显像有异常浓聚和血清HTg异常升高。 结论 :DTC术后及 13 1I治疗后 ,常规进行血清HTg测定和 13 1I全身显像检查 ,对早期发现复发或有无转移灶、13 1I治疗方案的选择以及评估 13 1I疗效具有重要的临床价值。OBJECTIVE:To evaluate the utility of serum thyroglobulin (Tg) and iodine 131 whole body scanning ( 131 I WBS) in the follow up of differentiated thyroid carcinoma (DTC) after thyroid ablation.METHODS:Eighty five patients were enrolled in the study.Serum HTg measurement was performed after 4-6 weeks′withdrawal of thyroxine and 30-day′s diet without iodine. 131 I WBS was undergone 24 hours or 4-7 days after oral administration of a diagnostic dosage (185-370 MBq) or therapeutic dosage.RESULTS:In 38 of 61 patients (62 30%) with relapsed or metastatic differentiated thyroid carcinoma clinically verified,HTg values increased over normal range.The HTg elevation was more evident in the patients with lung or bone metastasis.The serum HTg level displayed downtrend accompanied with the increment of the therapeutic dosage in 22 patients with lung or bone metastasis.In 53 patients (86 88%),the results of 131 I WBS and/or serum HTg measurement were positive.Among these patients,both abnormally radioactive uptake in 131 I WBS and elevation of serum HTg were found in only 30 patients (49 18%).CONCLUSIONS:Routine serum HTg measurement and 131 I WBS in patients with DTC after thyroidectomy is essential.It is of greatly clinical value in early detecting metastatic nidus,optimizing the treatment protocol and evaluating the curative effect.

关 键 词：甲状腺肿瘤 放射性核素显像 甲状腺肿瘤 治疗 甲状腺球蛋白 分析 随访研究 

分 类 号：R736.1[医药卫生—肿瘤]