Colacchio T A, LoGerfo P, Colacchio D A, Feind C
Surgery. 1982 Jan;91(1):42-5.
Two groups of patients were studied to compare the efficacy of serum thyroglobulin (Tg) levels to 131I total body scans in the follow-up of patients with thyroid cancer. All of the group of 30 patients without recurrence had undetectable Tg levels on and off thyroid hormone replacement, and all had negative total body scan results although eight patients showed uptake in remnant thyroid tissue. In the second group of 37 patients with documented recurrent or metastatic disease, 34 (92%) had positive serum Tg levels, although the levels in five of these patients were undetectable while on thyroid replacement, and 31 (84%) had positive total body scan results. The false negative results of the two tests were not overlapping, and of those with positive Tg levels, 29 showed a significant increase once thyroid hormone therapy had been withdrawn. We conclude that although the percentages of positive Tg levels and body scan results in patients with recurrent disease are similar, both tests are required to minimize the number of patients with undiagnosed metastases. Second, thyroid-stimulating hormone suppression has a definite although unpredictable effect on serum Tg levels in patients with thyroid cancer, and thyroid hormone should be withdrawn prior to measurement of serum Tg to minimize the number of false negative results.
对两组患者进行了研究，以比较血清甲状腺球蛋白（Tg）水平与131I全身扫描在甲状腺癌患者随访中的疗效。在30例无复发的患者组中，无论是否进行甲状腺激素替代治疗，其Tg水平均无法检测到，尽管有8例患者的残留甲状腺组织有摄取，但所有患者的全身扫描结果均为阴性。在第二组37例有复发或转移疾病记录的患者中，34例（92%）血清Tg水平为阳性，尽管其中5例患者在进行甲状腺替代治疗时Tg水平无法检测到，31例（84%）全身扫描结果为阳性。两种检查的假阴性结果不重叠，在Tg水平为阳性的患者中，29例在停用甲状腺激素治疗后显示有显著升高。我们得出结论，尽管复发疾病患者中Tg水平阳性和全身扫描结果阳性的百分比相似，但两种检查都需要进行，以尽量减少未诊断出转移的患者数量。其次，促甲状腺激素抑制对甲状腺癌患者的血清Tg水平有明确但不可预测的影响，在测量血清Tg之前应停用甲状腺激素，以尽量减少假阴性结果的数量。
