Harvey R D, Matheson N A, Grabowski P S, Rodger A B
Department of Medicine, University of Aberdeen, Foresterhill, UK.
Br J Surg. 1990 Mar;77(3):324-6. doi: 10.1002/bjs.1800770329.
Serum thyroglobulin was measured in 243 samples from 84 patients (20 men and 64 women, with a mean age of 48.9(14) years) with differentiated thyroid carcinoma treated by lobectomy, and in 58 patients treated by total thyroidectomy. Both groups were given thyroxine to suppress thyroid stimulating hormone (TSH). Three patients in the lobectomy group and eight in the thyroidectomy group had evidence of tumour recurrence. Serum thyroglobulin concentration was elevated in the presence of known recurrent tumour (P less than 0.001) irrespective of the type of operation, and in its absence tended to be higher in the lobectomy than in the thyroidectomy group (median 4 micrograms/l versus 2 micrograms/l, P less than 0.05). Serum thyroglobulin levels of less than 10 micrograms/l could confirm the absence of otherwise known tumour recurrence in both groups with a specificity of 100 per cent, and sensitivities of 80 per cent and 86 per cent in the lobectomy and thyroidectomy groups respectively. Exclusion of samples liable to spurious elevation of thyroglobulin improved the sensitivity in the lobectomy group to 92 per cent. Despite the presence of residual thyroid tissue, measurement of serum thyroglobulin can exclude the presence of significant metastases in most patients following lobectomy for thyroid carcinoma.
对84例接受叶切除术的分化型甲状腺癌患者（20例男性和64例女性，平均年龄48.9（14）岁）的243份样本以及58例接受全甲状腺切除术的患者的样本进行了血清甲状腺球蛋白检测。两组患者均给予甲状腺素以抑制促甲状腺激素（TSH）。叶切除术组有3例患者和甲状腺切除术组有8例患者有肿瘤复发迹象。无论手术类型如何，在已知肿瘤复发的情况下血清甲状腺球蛋白浓度都会升高（P<0.001），而在无复发的情况下，叶切除术组的血清甲状腺球蛋白浓度往往高于甲状腺切除术组（中位数分别为4μg/L和2μg/L，P<0.05）。血清甲状腺球蛋白水平低于10μg/L可确定两组中无其他已知的肿瘤复发，特异性为100%，叶切除术组和甲状腺切除术组的敏感性分别为80%和86%。排除易导致甲状腺球蛋白假性升高的样本后，叶切除术组的敏感性提高到92%。尽管存在残留甲状腺组织，但对于大多数接受甲状腺癌叶切除术的患者，检测血清甲状腺球蛋白可排除存在显著转移的情况。
