Moser E, Fritsch S, Braun S
Department of Radiology, University of Munich, Federal Republic of Germany.
Nucl Med Commun. 1988 Apr;9(4):262-6.
In 158 thyroidectomized patients with well-differentiated non-metastatic thyroid cancer the results of serum thyroglobulin (Tg) determination and 131I uptake values established immediately before radioiodine treatment (19 days after surgery) were compared. In 113 patients (72%) Tg was above 6 ng ml-1 (lower limit of detection) and 131I uptake exceeded 2%. In 11 patients (7%) Tg was undetectable and 131I uptake less than 2%. In these cases a radioiodine treatment was not performed; the thyroid ablation was achieved by surgery only. In 34 patients (21%) with undetectable Tg, 131I uptake values, however, varied between 3 and 46% (mean value: 9.6%). Only in 4 of these 34 patients was TSH not maximally (50 microU ml-1) stimulated because of a shorter (9, 10, 11, 13 days) period from thyroidectomy. In conclusion, remaining thyroid tissue, highly stimulated by TSH, can trap a remarkable amount of radioiodine, but may be unable to produce detectable amounts of Tg. Therefore, in contrast to 131I, measuring Tg is insufficient to document the success of thyroid ablation. For the first follow-up study after ablative therapy, the uptake test with radioiodine is mandatory.
对158例分化良好的非转移性甲状腺癌甲状腺切除患者，比较了放射性碘治疗前（术后19天）即刻测定的血清甲状腺球蛋白（Tg）结果和131I摄取值。113例患者（72%）Tg高于6 ng/ml（检测下限），131I摄取超过2%。11例患者（7%）Tg检测不到，131I摄取低于2%。在这些病例中未进行放射性碘治疗；仅通过手术实现甲状腺切除。在34例Tg检测不到的患者中，131I摄取值在3%至46%之间变化（平均值：9.6%）。在这34例患者中，仅4例由于甲状腺切除术后时间较短（9、10、11、13天），TSH未达到最大刺激值（50 μU/ml）。总之，受TSH高度刺激的残留甲状腺组织可摄取大量放射性碘，但可能无法产生可检测量的Tg。因此，与131I不同，检测Tg不足以证明甲状腺切除是否成功。对于消融治疗后的首次随访研究，放射性碘摄取试验是必需的。
