Department of Surgery, Division of Breast and Endocrine Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
School of Clinical Medicine, The University of Queensland, Brisbane, Queensland, Australia.
ANZ J Surg. 2021 Apr;91(4):724-729. doi: 10.1111/ans.16459. Epub 2020 Nov 26.
An increasing number of patients with low and moderate risk differentiated thyroid cancer (DTC) are now managed with lobectomy alone. The value of serum thyroglobulin (Tg) in the follow up of these patients remains poorly defined.
A review of the MEDLINE and EMBASE databases was performed to assess the utility of Tg in the follow up of patients undergoing thyroid lobectomy for DTC.
A total of five retrospective reviews were identified including 1136 patients undergoing hemithyroidectomy with or without prophylactic central neck dissection. The overall locoregional recurrence rate was 3.7%. Changes in serum Tg following hemithyroidectomy for cancer were found to be clinically useful in one study only. The proposed cut-off value of 30 ng/mL following hemithyroidectomy as a predictor of recurrent disease was not validated by any study.
Serum Tg values are not useful in the follow up of DTC patients managed with lobectomy alone. Good quality neck ultrasound appears to be an effective modality in the detection of locoregional recurrence in these patients while research efforts continue to identify and validate novel biomarkers.
越来越多低危和中危分化型甲状腺癌（DTC）患者现在仅接受甲状腺叶切除术治疗。在这些患者的随访中，血清甲状腺球蛋白（Tg）的价值仍未得到明确界定。
对 MEDLINE 和 EMBASE 数据库进行了回顾，以评估 Tg 在接受 DTC 甲状腺叶切除术患者随访中的应用价值。
共确定了 5 项回顾性研究，包括 1136 例接受甲状腺叶切除术（伴或不伴预防性中央颈部清扫术）的患者。局部区域复发率总体为 3.7%。只有一项研究发现，甲状腺癌患者甲状腺叶切除术后血清 Tg 的变化具有临床意义。任何研究均未证实术后 30ng/mL 作为复发病灶预测值的 Tg 截断值。
在仅接受甲状腺叶切除术治疗的 DTC 患者随访中，血清 Tg 值无作用。高质量的颈部超声似乎是检测这些患者局部区域复发的有效方法，同时研究工作也在继续寻找和验证新的生物标志物。
