College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
Head Neck. 2014 Feb;36(2):155-7. doi: 10.1002/hed.23272. Epub 2013 Jun 1.
The purpose of this study was to demonstrate a role for observation of patients with differentiated thyroid cancer (DTC) with persistent, nonlocalizable disease.
Our study was conducted on outpatients seen at our institution from 1999 to 2009 having total thyroidectomy, radioactive iodine (RAI) ablation, measurable serum thyroglobulin (Tg), and no evidence of disease on whole body or positron emission tomography (PET) scans.
Nineteen patients in our study group aged 20 to 73 with an average follow-up of 5.5 years (range, 2-12 years); all were treated with postoperative RAI (99-210 mCi, average 119). Mean Tg ranged from 0.41 to 4.34. Tg levels remained stable or gradually decreased in all patients.
After total thyroidectomy and RAI therapy, patients may present with mildly elevated Tg values without localizable disease. These patients may have additional RAI treatments based on the Tg elevation. However, our clinical experience has shown that many of these patients will have Tg levels that either achieve stability or decrease over time without further treatment.
本研究旨在证明观察分化型甲状腺癌（DTC）患者持续性、不可定位疾病的作用。
我们的研究对象为 1999 年至 2009 年间在我院就诊的门诊患者，这些患者均接受了全甲状腺切除术、放射性碘（RAI）消融术、可测量的血清甲状腺球蛋白（Tg），且全身或正电子发射断层扫描（PET）扫描无疾病证据。
在我们的研究组中，19 名年龄在 20 至 73 岁之间的患者，平均随访时间为 5.5 年（范围为 2-12 年）；所有患者均接受术后 RAI（99-210 mCi，平均 119 mCi）治疗。Tg 水平范围为 0.41 至 4.34。所有患者的 Tg 水平均保持稳定或逐渐下降。
在全甲状腺切除术和 RAI 治疗后，患者可能会出现轻度升高的 Tg 值而无可定位的疾病。这些患者可能会根据 Tg 升高接受额外的 RAI 治疗。然而，我们的临床经验表明，许多此类患者的 Tg 水平将随着时间的推移而趋于稳定或下降，无需进一步治疗。
