Kishino B
Nihon Naibunpi Gakkai Zasshi. 1978 Jan 20;54(1):43-53. doi: 10.1507/endocrine1927.54.1_43.
A sensitive and specific double antibody radioimmunoassay for the measurement of serum thyroglobulin (Tg) has been developed. The minimum detectable concentration of Tg was 5.0 ng/ml. Coefficients of within and between assay variation were 2.4% and 12.0%, respectively. The mean recovery of Tg added to normal serum was 102.9%; and T4, T3, DIT and MIT did not crossreact in this assay system. Dilution curves of normal thyroid extract, tumor extract and patient's serum were shown to be parallel with the standard Tg preparation. The mean serum Tg level in normal males and females was 42.8 +- 5.3 ng/ml (mean +- SE) (N=29) and 117.1 +- 20.9 ng/ml (N=20), respectively. There was a significant difference between male and female groups (p less than 0.001). The mean serum Tg level was 365.0 +- 69 ng/ml in 19 hyperthyroid patients with Graves' disease and 248.1 +- 35.8 ng/ml in 21 patients who were in a euthyroid state from the treatment with antithyroid drugs, showing statistically no significant difference. However, 8 patients in permanent remission showed definitely low Tg values, 83.6 +- 16.2 ng/ml. The mean serum Tg level was 2101.1 +- 57.6 ng/ml in 6 patients with chronic thyroiditis without auto-anti Tg and 525.1 +- 207.5 ng/ml in 5 patients with thyroid adenoma. The effect of total thyroidectomy on the serum TSH and Tg was studied in a patient (M.T.) with pulmonary metastases from thyroid follicular adenocarcinoma. The serum TSH level rose progressively to hypothyroid levels during nine days after thyroidectomy; the value was 45.7 muU/ml on the 9th day after the thyroidectomy. The serum Tg level in this case was 4 925 ng/ml before surgery. After a transient fluctuation caused by the operation, the serum Tg level in the patient increased progressively during 39 days after surgery with a concomitant increase in serum TSH; the levels at the 3rd, 6th and 9th day after surgery were 5,825 ng/ml, 7,910 ng/ml and 11,190 ng/ml, respectively. The suppression of endogenous TSH secretion with treatment of T3 60 MICROGRAMS/DAY WAS FOLLOWED BY A GRADUAL FALL In serum Tg levels, decreasing to 630 ng/ml at the 114th day. Bovine TSH was administered to this patient at the 114th day, so as to study the effect of exogeneous TSH on serum Tg. Serum Tg reached a maximal peak at the 24 hr. after bovine TSH injection. The maximal increase of serum Tg above baseline was 221%. Despite complete removal of the thyroid gland, the increase in serum Tg after thyroidal stimulation with endogenous and exogenous TSH was observed in the patient. In addition, the increase in serum Tg after bovine TSH injection was also observed in two patients with differentiated thyroid carcinoma who underwent a total thyroidectomy and had only metastatic tissue. These results indicate that the elevated serum Tg was released from metastatic tissue by TSH. The present study demonstrates direct evidence that metastatic tissue from thyroid carcinoma is responsive to TSH...
已开发出一种用于测量血清甲状腺球蛋白（Tg）的灵敏且特异的双抗体放射免疫测定法。Tg的最低可检测浓度为5.0 ng/ml。批内和批间变异系数分别为2.4%和12.0%。添加到正常血清中的Tg的平均回收率为102.9%；在该测定系统中，T4、T3、二碘甲状腺原氨酸（DIT）和一碘甲状腺原氨酸（MIT）无交叉反应。正常甲状腺提取物、肿瘤提取物和患者血清的稀释曲线与标准Tg制剂平行。正常男性和女性的血清Tg平均水平分别为42.8±5.3 ng/ml（平均值±标准误）（N = 29）和117.1±20.9 ng/ml（N = 20）。男性和女性组之间存在显著差异（p＜0.001）。19例格雷夫斯病甲亢患者的血清Tg平均水平为365.0±69 ng/ml，21例接受抗甲状腺药物治疗处于甲状腺功能正常状态的患者的血清Tg平均水平为248.1±35.8 ng/ml，统计学上无显著差异。然而，8例永久缓解的患者显示Tg值明显较低，为83.6±16.2 ng/ml。6例无抗Tg自身抗体的慢性甲状腺炎患者的血清Tg平均水平为2101.1±57.6 ng/ml，5例甲状腺腺瘤患者的血清Tg平均水平为525.1±207.5 ng/ml。在一名患有甲状腺滤泡腺癌肺转移的患者（M.T.）中研究了全甲状腺切除对血清促甲状腺激素（TSH）和Tg的影响。甲状腺切除术后9天内，血清TSH水平逐渐升至甲状腺功能减退水平；甲状腺切除术后第9天的值为45.7 μU/ml。该患者术前血清Tg水平为4925 ng/ml。术后经短暂波动后，患者血清Tg水平在术后39天内逐渐升高，同时血清TSH升高；术后第3、6和9天的水平分别为5825 ng/ml、7910 ng/ml和11190 ng/ml。每天用60微克T3治疗抑制内源性TSH分泌后，血清Tg水平逐渐下降，在第114天降至630 ng/ml。在第114天给该患者注射牛TSH，以研究外源性TSH对血清Tg的影响。注射牛TSH后2小时血清Tg达到最大峰值。血清Tg较基线的最大增幅为221%。尽管甲状腺已完全切除，但在该患者中观察到内源性和外源性TSH刺激甲状腺后血清Tg升高。此外，在另外两名接受全甲状腺切除术且仅存在转移组织的分化型甲状腺癌患者中也观察到注射牛TSH后血清Tg升高。这些结果表明，升高的血清Tg是由TSH从转移组织中释放出来的。本研究证明了甲状腺癌转移组织对TSH有反应的直接证据……
