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甲状腺切除术后消融前血清甲状腺球蛋白水平联合消融后131I全身显像对分化型甲状腺癌患者成功消融的预测价值

Predictive value of the preablation serum thyroglobulin level after thyroidectomy is combined with postablation 131I whole body scintigraphy for successful ablation in patients with differentiated thyroid carcinoma.

作者信息

Lee Hyo Jin, Rha So Young, Jo Young Suk, Kim Seong Min, Ku Bon Jeong, Shong Minho, Kim Young Kun, Ro Heung Kyu

机构信息

Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.

出版信息

Am J Clin Oncol. 2007 Feb;30(1):63-8. doi: 10.1097/01.coc.0000239138.64949.0a.

Abstract

OBJECTIVES

To investigate the clinical importance of the combined use of serum thyroglobulin (Tg) levels measured just before ablation (ablation-Tg) and postablation 131I whole body scintigraphy (WBS) patterns for predicting ablation success in patients with differentiated thyroid carcinoma who received total thyroidectomy and 131I ablation therapy.

METHODS

We retrospectively studied the early clinical outcomes for 81 differentiated thyroid carcinoma patients treated with total thyroidectomy and high-dose 131I ablation therapy between June 2001 and July 2004.

RESULTS

Ablation success was achieved in 42 (97.7%) of the 43 patients with uptake in the thyroid bed only and ablation-Tg levels less than 10 ng/mL, whereas successful ablation was achieved in 9 (75.0%) of the 12 patients with uptake in the thyroid bed only and ablation-Tg levels equal to or greater than 10 ng/mL (P = 0.029). Among 15 patients with uptake including a lymph node and ablation-Tg levels less than 10 ng/mL, 14 patients (93.3%) showed ablation success, whereas successful ablation was achieved in only 2 (18.2%) of the 11 patients with uptake including a lymph node and ablation-Tg levels equal to or greater than 10 ng/mL (P < 0.001).

CONCLUSIONS

These data indicate that the combined use of serum Tg levels measured just before ablation and the 131I WBS patterns after ablation may be an early predictor of ablation success in patients with differentiated thyroid carcinoma who received total thyroidectomy and high-dose 131I ablation therapy.

摘要

目的

探讨在接受甲状腺全切术及131I消融治疗的分化型甲状腺癌患者中,消融前测定的血清甲状腺球蛋白(Tg)水平(消融-Tg)与消融后131I全身显像(WBS)模式联合应用对预测消融成功的临床重要性。

方法

我们回顾性研究了2001年6月至2004年7月期间接受甲状腺全切术及高剂量131I消融治疗的81例分化型甲状腺癌患者的早期临床结局。

结果

43例仅甲状腺床有摄取且消融-Tg水平低于10 ng/mL的患者中,42例(97.7%)消融成功;而12例仅甲状腺床有摄取且消融-Tg水平等于或高于10 ng/mL的患者中,9例(75.0%)消融成功(P = 0.029)。15例有包括淋巴结摄取且消融-Tg水平低于10 ng/mL的患者中,14例(93.3%)显示消融成功;而11例有包括淋巴结摄取且消融-Tg水平等于或高于10 ng/mL的患者中,仅2例(18.2%)消融成功(P < 0.001)。

结论

这些数据表明,消融前测定的血清Tg水平与消融后131I WBS模式联合应用,可能是接受甲状腺全切术及高剂量131I消融治疗的分化型甲状腺癌患者消融成功的早期预测指标。

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