RAI 难治性甲状腺癌患者血糖控制与血清甲状腺球蛋白水平之间的相关性

JCEM case reports Pub Date : 2024-05-03 eCollection Date: 2024-05-01 DOI:10.1210/jcemcr/luae085
Yuji Hataya, Takumi Nomura, Yuko Fujishima, Kanta Fujimoto, Toshio Iwakura, Naoki Matsuoka
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摘要

糖尿病是甲状腺癌发病的一个危险因素。血清甲状腺球蛋白(Tg)水平是监测放射性碘(RAI)难治性甲状腺癌的敏感而特异的肿瘤标志物;然而,人们对血糖控制对血清Tg水平的影响知之甚少。在此,我们介绍了一例患有 RAI 难治性甲状腺癌肺转移的女性患者,血糖控制可能对其血清 Tg 水平产生了影响。尽管接受了促甲状腺激素抑制治疗,但她的血清 Tg 水平仍然升高。随后,她患上了2型糖尿病,并接受了长达6年的抗糖尿病药物治疗。在整个糖尿病治疗过程中,她的血清 Tg 水平随血糖控制水平的变化而波动,并与血红蛋白 A1c 水平密切相关(r = 0.92,P < .01)。与癌胚抗原和碳水化合物抗原 19-9 等其他肿瘤标志物的血清水平类似,Tg 的血清水平也会受到血糖控制的影响。因此,在监测 RAI 难治性甲状腺癌合并糖尿病患者的血清 Tg 水平时应注意血糖控制。
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Correlation Between Glycemic Control and Serum Thyroglobulin Levels in a Patient With RAI-Refractory Thyroid Cancer.

Diabetes is a risk factor for thyroid cancer development. Serum thyroglobulin (Tg) levels are useful as sensitive and specific tumor markers for monitoring radioiodine (RAI)-refractory thyroid cancer; however, the impact of glycemic control on serum Tg levels is poorly understood. Here, we present a case of a female patient with lung metastases of RAI-refractory thyroid cancer in whom glycemic control may have influenced the serum Tg levels. Despite receiving thyroid-stimulating hormone suppression therapy, her serum Tg levels remained elevated. Subsequently, she developed type 2 diabetes and was administered antidiabetic medications for 6 years. Throughout the course of diabetes management, her serum Tg levels fluctuated according to the level of glycemic control, showing a strong correlation with her hemoglobin A1c levels (r = 0.92, P < .01). Similar to the serum levels of other tumor markers, such as the carcinoembryonic antigen and carbohydrate antigen 19-9, the serum levels of Tg can be influenced by glycemic control. Therefore, serum Tg levels in patients with RAI-refractory thyroid cancer and diabetes should be monitored with attention to glycemic control.

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