甲状腺球蛋白检测不清使得123I全身扫描和促甲状腺球蛋白在分化型甲状腺癌的随访治疗中不再适用。

IF 1.9 Q3 ENDOCRINOLOGY & METABOLISM Thyroid Research Pub Date : 2021-10-19 DOI:10.1186/s13044-021-00114-0
Bastiaan Sol, Bert Bravenboer, Brigitte Velkeniers, Steven Raeymaeckers, Marleen Keyaerts, Corina Emilia Andreescu
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引用次数: 0

摘要

背景:分化型甲状腺癌(DTC)是一种常见的恶性肿瘤,发病率越来越高。DTC的随访护理包括甲状腺球蛋白(Tg)测量和颈部超声(US),并在有指征时联合131I残余消融。随着新的高灵敏度tg测定法(灵敏度≤0.1 ng/mL)的引入,诊断精度不断提高。该研究的目的是确定高敏感Tg的预后效用和对DTC的其他诊断试验的需求。方法:回顾性观察性研究。本研究选择2013年10月至2018年12月期间,在我院接受甲状腺全切除术及131I残肢消融治疗的病理证实的DTC患者。排除可能有甲状腺球蛋白自身抗体干扰的受试者。采用IBM SPSS®Statistics 24软件包进行统计分析。结果:40例患者符合分析条件。40例患者中有24例(60%)在全甲状腺切除术后6个月有检测不到的高敏感Tg。随访1年后,这些患者的刺激Tg均未超过1 ng/mL, 123I全身扫描(WBS)也未发现残留。术后6至12个月进行颈部超声检查,24例患者中有21例为阴性。结论:本研究表明,检测不到的高敏感Tg可以改变DTC患者的管理,减少刺激Tg和123I WBS的使用和需求。
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Undetectable thyroglobulin makes 123I whole-body scan and stimulated thyroglobulin obsolete in follow-up care of differentiated thyroid cancer: a retrospective study.

Background: Differentiated thyroid cancer (DTC) is a common malignancy with increasing incidence. Follow-up care for DTC includes thyroglobulin (Tg) measurement and ultrasound (US) of the neck, combined with 131I remnant ablation when indicated. Diagnostic precision has evolved with the introduction of the new high-sensitive Tg-assays (sensitivity ≤0.1 ng/mL). The aim of the study was to determine the prognostic utility of high-sensitive Tg and the need for other diagnostic tests in DTC.

Methods: This was a retrospective, observational study. Patients with pathologically confirmed DTC, treated with total thyroidectomy and 131I remnant ablation, who had their complete follow-up care in our institution were selected (October 2013-December 2018). Subjects with possible thyroglobulin autoantibody interference were excluded. Statistical analysis was performed using the IBM SPSS® Statistics 24 software package.

Results: Forty patients were eligible for analysis. A total of 24 out of the 40 patients (60%) had an undetectable high-sensitive Tg 6 months after total thyroidectomy. None of these patients had a stimulated Tg above 1 ng/mL, or remnant on the 123I Whole-Body Scan (WBS) after 1 year of follow-up. Ultrasound of the neck, performed between 6 and 12 months postoperative, was negative in 21 out of the 24 patients.

Conclusions: This study shows that an undetectable high-sensitive Tg can change the management of patients with DTC and decrease the use and need of stimulated Tg and 123I WBS.

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来源期刊
Thyroid Research
Thyroid Research Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
3.10
自引率
4.50%
发文量
21
审稿时长
8 weeks
期刊最新文献
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