Pacini F, Martino E, Bambini G, Aghini-Lombardi F, Taddei D, Lari R, Pinchera A, Baschieri L
Cancer Detect Prev. 1985;8(1-2):17-22.
We investigated the usefulness and limits of serum thyroglobulin, serum calcitonin, and serum tissue polypeptide antigen as humoral markers for thyroid carcinoma in 364 patients with papillary, follicular, medullary, and undifferentiated types of thyroid cancer. In agreement with other studies we found that serum thyroglobulin was a specific and sensitive marker for well-differentiated thyroid cancer after total thyroidectomy. Lymph node, lung, and bone metastases were associated with high serum thyroglobulin concentrations, both during and after thyroid-suppressive therapy with L-thyroxine. Serum thyroglobulin determination was superior to whole body scanning in predicting the presence of differentiated metastases, because patients with nonfunctioning metastases and negative whole body scan also had high levels of serum thyroglobulin. Serum calcitonin levels were increased in all patients with active medullary thyroid cancer, confirming the specificity of this marker in detecting tumors arising from parafollicular C-cells. Furthermore, in medullary thyroid cancer serum tissue polypeptide antigen levels were also increased in most patients. This last substance was found to be increased also in undifferentiated thyroid cancer. Of particular interest was the finding of increased serum tissue polypeptide antigen levels in 15 cases of differentiated thyroid cancer, whose metastases underwent a progressive process of "dedifferentiation."
我们研究了血清甲状腺球蛋白、血清降钙素和血清组织多肽抗原作为甲状腺癌体液标志物在364例乳头状、滤泡状、髓样和未分化型甲状腺癌患者中的有用性和局限性。与其他研究一致，我们发现血清甲状腺球蛋白是全甲状腺切除术后分化型甲状腺癌的特异性和敏感标志物。在使用左旋甲状腺素进行甲状腺抑制治疗期间和之后，淋巴结、肺和骨转移均与血清甲状腺球蛋白浓度升高有关。血清甲状腺球蛋白测定在预测分化型转移灶的存在方面优于全身扫描，因为无功能转移灶且全身扫描阴性的患者血清甲状腺球蛋白水平也很高。所有活动性髓样甲状腺癌患者的血清降钙素水平均升高，证实了该标志物在检测滤泡旁C细胞来源肿瘤方面的特异性。此外，在髓样甲状腺癌中，大多数患者的血清组织多肽抗原水平也升高。发现这种最后一种物质在未分化甲状腺癌中也升高。特别有趣的是，在15例分化型甲状腺癌中发现血清组织多肽抗原水平升高，这些病例的转移灶经历了一个逐渐“去分化”的过程。
