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[甲状腺癌甲状腺切除术后患者三周甲状腺球蛋白检测的临床意义]

[Clinical significance of three-week thyroglobulin test in patients with thyroid cancer undergoing thyroidectomy].

作者信息

Vasil'ev D A, Poroshina T E, Radzhabova Z A-G, Bershteĭn L M

出版信息

Vopr Onkol. 2012;58(4):481-5.

PMID:23607201
Abstract

High level of thyroglobulin (Tg) after thyroidectomy has been shown to be an early marker of either metastases or local recurrence of differentiated thyroid cancer (DTC). The aim of this study was to evaluate the relation between Tg level estimated on the third week after thyroidectomy and clinic-pathologic characteristics of DTC as a possible prognostic criterion used to mark the patients with radioiodine therapy indications. Research data on 45 patients (39 women, 6 men, age 22-75 years) with DTC and without high level of Tg autoantibodies have been included in the study. Eleven patients underwent surgical treatment due to disease recurrence. In all patients Tg and thyroid hormones levels were measured before the thyroidectomy and on the third week after it. The postoperative level of Tg as TTM coefficient (ratio of postoperative Tg to daily L-thyroxin dose in mcg to body weight in kg) was higher in patients with unfavorable prognosis: (a) capsular invasion, (b) cervical lymph nodes metastases, (c) advanced disease stage, (d) high risk of recurrence. The postoperative serum Tg levels were similar in primary disease patients and patients with DTC recurrence. There was no relation between preoperative Tg level and any prognostic factors although there was a tendency to higher (more than 2 ng/ml) Tg levels in patents with high preoperative Tg levels. Finally, the serum Tg level on the third week after thyroidectomy is a valuable prognostic criterion and can be used in DTC to determine the radioiodine therapy indications.

摘要

甲状腺切除术后甲状腺球蛋白(Tg)水平升高已被证明是分化型甲状腺癌(DTC)转移或局部复发的早期标志物。本研究的目的是评估甲状腺切除术后第三周估算的Tg水平与DTC临床病理特征之间的关系,作为用于标记有放射性碘治疗指征患者的可能预后标准。本研究纳入了45例(39例女性,6例男性,年龄22 - 75岁)患有DTC且Tg自身抗体水平不高的患者的研究数据。11例患者因疾病复发接受了手术治疗。在所有患者中,在甲状腺切除术前及术后第三周测量Tg和甲状腺激素水平。预后不良的患者术后Tg作为TTM系数(术后Tg与每日L - 甲状腺素剂量微克数与体重千克数之比)较高:(a)包膜侵犯,(b)颈部淋巴结转移,(c)疾病晚期,(d)高复发风险。原发性疾病患者和DTC复发患者术后血清Tg水平相似。术前Tg水平与任何预后因素均无关联,尽管术前Tg水平高的患者(超过2 ng/ml)有Tg水平更高(超过2 ng/ml)的趋势。最后,甲状腺切除术后第三周的血清Tg水平是一个有价值的预后标准,可用于DTC以确定放射性碘治疗指征。

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