Department of Medicine, King Saud University, Riyadh, Saudi Arabia.
Obesity Research Center, King Saud University, Riyadh, Saudi Arabia.
Front Endocrinol (Lausanne). 2021 Feb 24;11:603432. doi: 10.3389/fendo.2020.603432. eCollection 2020.
Following total thyroidectomy and radioactive iodine (RAI) ablation, serum thyroglobulin levels should be undetectable to assure that patients are excellent responders and at very low risk of recurrence.
To assess the utility of stimulated (sTg) and non-stimulated (nsTg) thyroglobulin levels in prediction of patients outcomes with differentiated thyroid cancer (DTC) following total thyroidectomy and RAI ablation.
A prospective observational study conducted at a University Hospital in Saudi Arabia. Patients diagnosed with differentiated thyroid cancer and were post total thyroidectomy and RAI ablation. Thyroglobulin levels (nsTg and sTg) were estimated 3-6 months post-RAI. Patients with nsTg <2 ng/ml were stratified based on their levels and were followed-up for 5 years and clinical responses were measured.
Of 196 patients, nsTg levels were <0.1 ng/ml in 122 (62%) patients and 0.1-2.0 ng/ml in 74 (38%). Of 122 patients with nsTg <0.1 ng/ml, 120 (98%) had sTg levels <1 ng/ml, with no structural or functional disease. sTg levels >1 occurred in 26 (35%) of patients with nsTg 0.1-2.0 ng/ml, 11 (15%) had structural incomplete response. None of the patients with sTg levels <1 ng/ml developed structural or functional disease over the follow-up period.
Suppressed thyroglobulin (nsTg < 0.1 ng/ml) indicates a very low risk of recurrence that does not require stimulation. Stimulated thyroglobulin is beneficial with nsTg 0.1-2 ng/ml for re-classifying patients and estimating their risk for incomplete responses over a 7 years follow-up period.
在全甲状腺切除术和放射性碘（RAI）消融后，血清甲状腺球蛋白水平应检测不到，以确保患者是优秀的应答者，并且复发的风险非常低。
评估刺激（sTg）和非刺激（nsTg）甲状腺球蛋白水平在预测全甲状腺切除和 RAI 消融后分化型甲状腺癌（DTC）患者结局中的作用。
在沙特阿拉伯的一家大学医院进行了一项前瞻性观察性研究。诊断为分化型甲状腺癌的患者，并在全甲状腺切除和 RAI 消融后进行治疗。在 RAI 后 3-6 个月估计甲状腺球蛋白水平（nsTg 和 sTg）。nsTg<2ng/ml 的患者根据其水平分层，并随访 5 年，测量临床反应。
在 196 例患者中，nsTg 水平<0.1ng/ml 的有 122 例（62%），0.1-2.0ng/ml 的有 74 例（38%）。在 nsTg<0.1ng/ml 的 122 例患者中，120 例（98%）sTg 水平<1ng/ml，无结构或功能疾病。nsTg 0.1-2.0ng/ml 的 26 例（35%）患者 sTg 水平>1，11 例（15%）结构不完全反应。在随访期间，无 sTg 水平<1ng/ml 的患者发生结构或功能疾病。
抑制性甲状腺球蛋白（nsTg<0.1ng/ml）表明复发风险非常低，不需要刺激。在 nsTg 0.1-2ng/ml 时，刺激甲状腺球蛋白对重新分类患者并估计他们在 7 年随访期间不完全反应的风险是有益的。
