Edmonds C J, Tellez M
Endocrinology Research Group, Northwick Park Hospital, Middlesex, UK.
Clin Endocrinol (Oxf). 1988 Feb;28(2):253-9. doi: 10.1111/j.1365-2265.1988.tb03662.x.
Ten of 502 patients presenting with thyroid cancer were hyperthyroid due to Graves' disease (4 patients), multinodular goitre (3), an autonomous functioning nodule (1) and a large functioning tumour (2). In addition eight patients had a past history of Graves' disease and four of hyperthyroidism associated with multinodular goitre. Mortality in patients with Graves' disease and with multinodular goitre appeared similar to that of other patients of comparable age. Both patients with large functioning tumours died from progressive disease. Concentration 131I by tumour metastases was present in one patient with active Graves' disease who had a high serum concentration of TSH-receptor binding antibodies, indicating that these antibodies may chronically stimulate tumour function. The potential for 131I concentration by tumour when TSH secretion is suppressed should therefore be determined in patients with Graves' disease and if demonstrable tumour function is present, reflecting stimulation by Graves' immunoglobulins, then elimination of tumour remnants is particularly important.
502例甲状腺癌患者中有10例因格雷夫斯病（4例）、多结节性甲状腺肿（3例）、自主性功能性结节（1例）和巨大功能性肿瘤（2例）而出现甲状腺功能亢进。此外，8例患者有格雷夫斯病病史，4例有与多结节性甲状腺肿相关的甲状腺功能亢进病史。格雷夫斯病和多结节性甲状腺肿患者的死亡率与其他年龄相仿的患者相似。2例巨大功能性肿瘤患者均死于疾病进展。1例活动性格雷夫斯病患者的肿瘤转移灶摄取了131I，其血清促甲状腺激素受体结合抗体浓度较高，表明这些抗体可能长期刺激肿瘤功能。因此，对于格雷夫斯病患者，当促甲状腺激素分泌受到抑制时，应确定肿瘤摄取131I的可能性，如果存在可证实的肿瘤功能，反映出格雷夫斯免疫球蛋白的刺激作用，那么清除肿瘤残余物就尤为重要。
