Lawal Ismaheel O, Nyakale Nozipho E, Harry Lerwine M, Lengana Thabo, Mokgoro Neo P, Vorster Mariza, Sathekge Mike M
aDepartment of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria bDepartment of Nuclear Medicine, University of Kwa-Zulu Natal, Durban, South Africa.
Nucl Med Commun. 2017 Mar;38(3):222-227. doi: 10.1097/MNM.0000000000000640.
Radioiodine ablation of remnant thyroid tissue is an important adjuvant therapy of differentiated thyroid carcinoma (DTC) after thyroidectomy. Elevated serum thyroid-stimulating hormone (TSH) level is necessary for successful ablation. The optimum level of serum TSH level necessary for successful radioiodine ablation of well-DTC is, however, yet to be defined. We aimed to determine whether higher serum TSH level will result in a better rate of complete ablation of well-DTC using iodine-131 (I) following initial thyroidectomy.
A total of 109 patients with differentiated thyroid cancer were divided into four treatment groups on the basis of serum TSH levels. They were followed up from 6 to 12 months after treatment with stimulated serum thyroglobulin level and a diagnostic whole-body scan with radioactive iodine I to determine early response.
Sixty-four patients had papillary thyroid carcinoma, whereas 45 patients had follicular carcinoma. An excellent response was observed in 66.7% of patients with TSH level more than 90 μIU/ml, 72.2% in the group with TSH level of 60-89 μIU/ml, 48.5% when TSH was 30-59 μIU/ml and 26.7% when TSH was less than 30 μIU/ml (P=0.002).
Higher preablative serum TSH predicts a better rate of ablation in patients with differentiated thyroid cancer treated with I after thyroidectomy.
甲状腺切除术后，放射性碘消融残余甲状腺组织是分化型甲状腺癌（DTC）的重要辅助治疗方法。血清促甲状腺激素（TSH）水平升高是成功消融的必要条件。然而，对于高分化DTC成功进行放射性碘消融所需的最佳血清TSH水平尚未明确。我们旨在确定较高的血清TSH水平是否会使初次甲状腺切除术后使用碘-131（I）治疗的高分化DTC患者获得更好的完全消融率。
总共109例分化型甲状腺癌患者根据血清TSH水平分为四个治疗组。治疗后6至12个月对他们进行随访，检测刺激后的血清甲状腺球蛋白水平，并进行放射性碘I诊断性全身扫描以确定早期反应。
64例患者患有乳头状甲状腺癌，45例患者患有滤泡状癌。TSH水平高于90μIU/ml的患者中66.7%观察到良好反应，TSH水平为60-89μIU/ml的组中为72.2%，TSH为30-59μIU/ml时为48.5%，TSH低于30μIU/ml时为26.7%（P=0.002）。
甲状腺切除术后接受I治疗的分化型甲状腺癌患者，术前血清TSH水平较高预示着消融率更高。
