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[分化型甲状腺癌患者血清内源性促甲状腺激素刺激条件下血清甲状腺球蛋白浓度测量结果解读标准的前瞻性分析]

[Prospective analysis of criteria for interpreting measurements of thyroglobulin serum concentration during conditions of endogenous TSH stimulation in serum of patients with differentiated thyroid carcinoma].

作者信息

Kukulska A, Gubała E, Turska M, Handkiewicz-Junak D, Czernik E, Deja R, Blamek S, Szpak S, Jarzab B

机构信息

Zakładu Medycyny Nuklearnej i Endokrynologii Onkologicznej, Centrum Onkologii-Instytut im. M. Skłodowskiej-Curie, Oddział w Gliwicach.

出版信息

Wiad Lek. 2001;54 Suppl 1:332-8.

Abstract

The aim of this study was the assessment of diagnostic value of thyroglobulin serum measurement in patients with DTC during endogenous TSH stimulation. Thyroglobulin was measured by immunofluorometric method (Delfia-Wallac) in patients after combined surgery and I131 ablation. Predictive values for two threshold levels 10 and 30 ng/ml were compared. At 5 years follow up it has been demonstrated, that Tg values higher than 10 ng/ml were the true signals of DTC relapse only in 46% patients. Tg values higher than 30 ng/ml were associated with disease progression in 65% of patients. Thus, we accept Tg concentration of 30 ng/ml measured during endogenous TSH stimulation as a good cut-off limit for the detection of DTC progression. Reduction of this threshold up to 10 ng/ml is associated with the increased risk of false positive results.

摘要

本研究的目的是评估内源性促甲状腺激素(TSH)刺激下血清甲状腺球蛋白测量对分化型甲状腺癌(DTC)患者的诊断价值。采用免疫荧光法(Delfia-Wallac)对接受联合手术及碘-131消融治疗后的患者进行甲状腺球蛋白检测。比较了10 ng/ml和30 ng/ml两个阈值水平的预测价值。在5年随访中发现,甲状腺球蛋白(Tg)值高于10 ng/ml时,仅46%的患者为DTC复发的真实信号。Tg值高于30 ng/ml时,65%的患者与疾病进展相关。因此,我们认为内源性TSH刺激下测量的Tg浓度为30 ng/ml是检测DTC进展的良好临界值。将该阈值降至10 ng/ml会增加假阳性结果的风险。

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