Chair and Clinic of Endocrinology Collegium Medicum, Jagiellonian University, Kraków, Poland.
Endokrynol Pol. 2010 Sep-Oct;61(5):474-9.
A group of differentiated thyroid carcinoma (DTC) patients receiving post thyroidectomy rhTSH-aided radioiodine treatment (group I) was compared with patients treated with ¹³¹I following endogenous stimulation of TSH (group II) after L-thyroxine withdrawal.
Group I consisted of 66 patients of mean age 51.7 ± 16.2 years (58 females and 8 males). Group II included 76 patients of mean age 54.8 ± 14.7 years (67 females and 9 males). All patients underwent total thyroidectomy and central lymph node dissection and additionally lateral lymph node excision, if required. Prior to radioiodine treatment thyroid volume (VT) and 24-hour ¹³¹I uptake were evaluated. TSH and Tg concentrations were measured prior to and after endogenous and exogenous stimulation of TSH. Whole-body post-therapeutic scintigraphy was evaluated. Basic statistics, W Shapiro-Wilk, Wilcoxon, and U Mann-Whitney tests were applied.
Median values of VT and of 24-hr ¹³¹I uptake in groups I and II were not significantly different. The differences between median values of serum TSH concentration after stimulation in groups I and II were statistically significant (p < 0.05), respective medians being 100.0 μU/mL (IQR = 107.3) and 78.8 μU/mL (IQR = 47.7). Median values of serum Tg concentrations in groups I and II following TSH stimulation prior to radioiodine treatment were 2.6 ng/ml (IQR = 8.4) and 4.9 ng/mL (IQR = 12.6), respectively, the difference not being statistically significant. Following rhTSH treatment no adverse effects were observed compared to LT4 withdrawal.
rhTSH may be safely used for ¹³¹I thyroid remnant ablation in low-risk DTC patients.
一组分化型甲状腺癌（DTC）患者在接受甲状腺切除术后 rhTSH 辅助放射性碘治疗（I 组），与接受 L-甲状腺素停药后 TSH 内源性刺激的¹³¹I 治疗（II 组）的患者进行了比较。
I 组包括 66 名平均年龄 51.7 ± 16.2 岁（58 名女性和 8 名男性）的患者。II 组包括 76 名平均年龄 54.8 ± 14.7 岁（67 名女性和 9 名男性）的患者。所有患者均接受了全甲状腺切除术和中央淋巴结清扫术，如果需要，还进行了侧方淋巴结切除术。在放射性碘治疗前评估甲状腺体积（VT）和 24 小时¹³¹I 摄取量。在 TSH 和 Tg 浓度进行内源性和外源性 TSH 刺激之前进行了测量。进行了全身治疗后闪烁扫描评估。应用基本统计学、W Shapiro-Wilk、Wilcoxon 和 U Mann-Whitney 检验。
I 组和 II 组的 VT 和 24 小时¹³¹I 摄取的中位数无显著差异。I 组和 II 组刺激后血清 TSH 浓度中位数之间的差异具有统计学意义（p < 0.05），分别为 100.0 μU/mL（IQR = 107.3）和 78.8 μU/mL（IQR = 47.7）。在接受放射性碘治疗之前，I 组和 II 组 TSH 刺激后血清 Tg 浓度的中位数分别为 2.6 ng/ml（IQR = 8.4）和 4.9 ng/mL（IQR = 12.6），差异无统计学意义。与 LT4 停药相比，rhTSH 治疗后未观察到不良反应。
rhTSH 可安全用于低危 DTC 患者的¹³¹I 甲状腺残余消融。
