对于低危乳头状甲状腺癌患者，甲状腺切除术后刺激甲状腺球蛋白轻度升高，是否需要进行¹³¹I消融治疗？
Is 131I ablation necessary for patients with low-risk papillary thyroid carcinoma and slightly elevated stimulated thyroglobulin after thyroidectomy?
作者信息
Rosario Pedro Weslley, Mourão Gabriela Franco
机构信息
Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil.
出版信息
Arch Endocrinol Metab. 2016 Feb;60(1):5-8. doi: 10.1590/2359-3997000000158.
Abstract
OBJECTIVE
This prospective study evaluated the recurrence rate in low-risk patients with papillary thyroid cancer (PTC) who presented slightly elevated thyroglobulin (Tg) after thyroidectomy and who did not undergo ablation with131I.
SUBJECTS AND METHODS
The study included 53 low-risk patients (nonaggressive histology; pT1b-3, cN0pNx, M0) with slightly elevated Tg after thyroidectomy (> 1 ng/mL, but ≤ 5 ng/mL after levothyroxine withdrawal or ≤ 2 ng/mL after recombinant human TSH).
RESULTS
The time of follow-up ranged from 36 to 96 months. Lymph node metastases were detected in only one patient (1.9%). Fifty-two patients continued to present negative neck ultrasound. None of these patients without apparent disease presented an increase in Tg.
CONCLUSIONS
Low-risk patients with PTC who present slightly elevated Tg after thyroidectomy do not require ablation with 131I.
摘要
目的
本前瞻性研究评估了甲状腺乳头状癌（PTC）低风险患者在甲状腺切除术后甲状腺球蛋白（Tg）轻度升高且未接受131I消融治疗时的复发率。
对象与方法
该研究纳入了53例低风险患者（组织学无侵袭性；pT1b - 3，cN0pNx，M0），这些患者在甲状腺切除术后Tg轻度升高（>1 ng/mL，但在停用左甲状腺素后≤5 ng/mL或在重组人促甲状腺素刺激后≤2 ng/mL）。
结果
随访时间为36至96个月。仅1例患者（1.9%）检测到淋巴结转移。52例患者颈部超声检查持续为阴性。这些无明显疾病的患者中，Tg均未升高。
结论
甲状腺切除术后Tg轻度升高的PTC低风险患者无需接受131I消融治疗。
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Is 131I ablation necessary for patients with low-risk papillary thyroid carcinoma and slightly elevated stimulated thyroglobulin after thyroidectomy?对于低危乳头状甲状腺癌患者，甲状腺切除术后刺激甲状腺球蛋白轻度升高，是否需要进行¹³¹I消融治疗？
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