Department of Nuclear Medicine, University Hospital, Goethe University, Theodor Stern Kai 7, D-60590 Frankfurt, Germany.
Department of Nuclear Medicine, Medizinisches Versorgungszentrum (MVZ), D-63739 Aschaffenburg, Germany.
Curr Oncol. 2022 May 31;29(6):4012-4019. doi: 10.3390/curroncol29060320.
Aim: Therapy success in patients with differentiated thyroid cancer (DTC) after thyroidectomy and radioiodine therapy (RIT) is proven by permanent decrease in human thyroglobulin (hTg) to <1 ng/mL. In this retrospective analysis hTg development before, during and after pregnancy were analyzed. Material and methods: A descriptive analysis of hTg courses in 47 women with 57 pregnancies under levothyroxine substitution was performed after treatment of DTC without evidence of residual or recurrent disease. We compared hTg levels before, during and after pregnancies. A median of four measurements were performed during pregnancy. Results: In five out of the 47 patients at least one hTg increase to ≥1.0 ng/mL occurred during pregnancy (P1: 1.1; P2: 1.75; P3: 1.0; P4: 1.1; P5: 1.07 ng/mL). In another three cases an increase to ≥0.5 ng/mL occurred. After delivery, all patients returned to undetectable hTg levels. Human Tg maxima during pregnancy were significantly elevated according to Friedman´s Chi2 and p Holm−Bonferroni. Conclusion: In women with ablative thyroid therapy after DTC, a temporary elevation in hTg levels during pregnancy may occur. The reason therefore remains unclear and requires further investigation.
分化型甲状腺癌(DTC)患者经甲状腺切除术和放射性碘治疗(RIT)后,人甲状腺球蛋白(hTg)永久性降至<1ng/mL 被证明是治疗成功的。本回顾性分析对 DTC 治疗后处于替代甲状腺素治疗且无残留或复发病灶的 47 名女性的 57 次妊娠中 hTg 的产前、产时和产后的发展情况进行了分析。
对 47 名女性的 hTg 水平进行了描述性分析,这些女性在 DTC 治疗后接受了替代甲状腺素治疗,且无残留或复发病灶。共有 57 次妊娠,共进行了 4 次中位数的 hTg 测量。
在 47 名患者中,有 5 名患者在妊娠期间至少有一次 hTg 升高至≥1.0ng/mL(P1:1.1;P2:1.75;P3:1.0;P4:1.1;P5:1.07ng/mL)。另外 3 例患者 hTg 升高至≥0.5ng/mL。分娩后,所有患者均恢复至 hTg 检测不到的水平。根据 Friedman 的 Chi2 和 p Holm−Bonferroni,妊娠期间 hTg 的最大值显著升高。
在接受 DTC 放射性碘消融治疗后的女性中,妊娠期间 hTg 水平可能会暂时升高。其原因尚不清楚,需要进一步研究。