Papageorgiou M S, Liratzopoulos N, Minopoulos G, Manolas K J
1st Department of Surgery, University General Hospital of Alexandroupolis, Greece.
S Afr J Surg. 2011 Aug 31;49(3):118-22.
Thyroglobulin (Tg) is used as a postoperative marker for the follow-up of patients with thyroid carcinoma, but there is no consensus regarding the value that may indicate possible recurrence. Aim. To evaluate Tg levels as a marker for recurrence of thyroid carcinoma.
Demographics and survival of 80 patients who underwent total thyroidectomy for well-differentiated thyroid cancer were analysed and related to Tg levels. Tg measurements were performed when patients were euthyroid, after completion of treatment.
The median Tg value was 1.3 ng/ml. Higher values were found in males, high-risk patients and patients with recurrent disease. Using the median Tg value as cut-off, patients were divided into two groups (group I ≤1.3 ng/ml and group II >1.3 ng/ml). There was a significant correlation between values >1.3 ng/ml and recurrence. When survival was related to Tg values, there was a tendency towards worse prognosis in group II. The best predictive cut-off value for recurrence was found to be 1.3 ng/ml, which had a sensitivity of 77% and a specificity of 57%.
Although low, a cut-off Tg level of 1.3 ng/ml represents a simple indication for further investigation in patients receiving thyroxine after completion of treatment for thyroid cancer, in the absence of measurement of anti-Tg auto-antibodies.
甲状腺球蛋白（Tg）用作甲状腺癌患者术后随访的标志物，但对于可能提示复发的数值尚无共识。目的：评估Tg水平作为甲状腺癌复发的标志物。
分析80例行全甲状腺切除术的分化型甲状腺癌患者的人口统计学资料和生存率，并与Tg水平相关联。在患者甲状腺功能正常且治疗结束后进行Tg测量。
Tg的中位数为1.3 ng/ml。男性、高危患者和复发患者的Tg值更高。以Tg中位数作为临界值，将患者分为两组（I组≤1.3 ng/ml，II组>1.3 ng/ml）。Tg值>1.3 ng/ml与复发之间存在显著相关性。当生存率与Tg值相关时，II组有预后较差的趋势。发现复发的最佳预测临界值为1.3 ng/ml，其敏感性为77%，特异性为57%。
尽管临界值较低，但在未检测抗Tg自身抗体的情况下，1.3 ng/ml的Tg临界水平是甲状腺癌治疗结束后接受甲状腺素治疗患者进一步检查的一个简单指标。
