Kanitz W, Böttger I G, Pabst H W, Heidenreich P, Dirr W
Krankenhausweckverband Augsburg.
Rofo. 1987 Sep;147(3):282-7. doi: 10.1055/s-2008-1048640.
The histories of 358 patients with carcinomas of the thyroid have been evaluated. Differentiated carcinomas of the thyroid (84.6%) were treated by means of thyroidectomy, ablative radio-iodine therapy (tissue dose 1000 Gray), TSH-suppressive thyroid hormone medication and, in special cases, external radiation. Even differentiated carcinomas showed a high recurrence rate. Metastases occurred particularly in the lungs, the skeleton and locally; low iodine uptake, particularly in distant metastases from papillary carcinomas, often made it impossible to reach a diagnosis by using radio-iodine. Some pulmonary metastases could only be demonstrated radiologically and some skeletal metastases could be shown radiologically or scintigraphically. A modified follow-up program for differentiated carcinomas is suggested, based on the highly sensitive and specific thyroglobulin determination under TSH suppression (sensitivity 97.9%, specificity 93.6%).
对358例甲状腺癌患者的病史进行了评估。甲状腺分化癌（84.6%）采用甲状腺切除术、消融性放射性碘治疗（组织剂量1000戈瑞）、促甲状腺激素抑制性甲状腺激素药物治疗，特殊情况下采用外照射治疗。即使是分化癌也显示出较高的复发率。转移尤其发生在肺、骨骼和局部；碘摄取低，特别是在乳头状癌的远处转移中，常常使得无法通过放射性碘进行诊断。一些肺转移只能通过放射学显示，一些骨骼转移可以通过放射学或闪烁扫描显示。基于促甲状腺激素抑制状态下高度敏感和特异的甲状腺球蛋白测定（敏感性97.9%，特异性93.6%），建议对分化癌采用改良的随访方案。
