Department of Radiology, Yale University School of Medicine, New Haven, Connecticut, USA.
Curr Opin Oncol. 2010 Jan;22(1):6-10. doi: 10.1097/CCO.0b013e3283339d5d.
The purpose of the review is to summarize the current findings of using recombinant human thyroid-stimulating hormone (rhTSH, also known as Thyrogen) as adjuvant stimulation for diagnostic monitoring, thyroid remnant ablation, and treatment of metastatic thyroid cancer.
A negative Thyrogen-stimulated thyroglobulin level has a negative predictive value of up to 98.5%. Therefore, it is unnecessary to repeat a Thyrogen-stimulated thyroglobulin level in the surveillance of patients with a negative result. There are no significant differences found in the rate of recurrence or persistent disease between Thyrogen-assisted and thyroid hormone withdrawal-ablated patient groups. Studies have shown that rapid clearance of excess radioiodine from the body in the euthyroid state with Thyrogen stimulation has significantly reduced whole body radiation exposure as compared with the hypothyroid state in withdrawal patients.
Thyrogen-assisted diagnosis and radioiodine ablation of thyroid remnant provide a reliable tool in the management of thyroid cancer without sacrificing patient quality of life. We believe that the use of Thyrogen for radioiodine treatment of metastatic thyroid cancer may also provide a better option due to its rapid preparation time and safety. Further prospective studies are required for the assessment of long-term outcomes.
本综述旨在总结使用重组人促甲状腺激素（rhTSH，也称为 Thyrogen）作为辅助刺激物进行诊断监测、甲状腺残留消融和转移性甲状腺癌治疗的最新发现。
Thyrogen 刺激后的甲状腺球蛋白水平呈阴性具有高达 98.5%的阴性预测值。因此，对于结果呈阴性的患者，无需重复进行 Thyrogen 刺激后的甲状腺球蛋白水平检测。Thyrogen 辅助治疗组和甲状腺激素撤药消融组的复发率或持续性疾病无显著差异。研究表明，与撤药患者的甲状腺功能减退状态相比，Thyrogen 刺激下的甲状腺功能正常状态下可迅速清除体内多余的放射性碘，从而显著降低全身辐射暴露。
Thyrogen 辅助诊断和甲状腺残留放射性碘消融为甲状腺癌的管理提供了一种可靠的工具，同时不会牺牲患者的生活质量。我们认为，由于 Thyrogen 准备时间短且安全，其用于转移性甲状腺癌的放射性碘治疗也可能是一种更好的选择。需要进一步的前瞻性研究来评估长期结果。
