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格雷夫斯病甲状腺次全切除术中促甲状腺激素结合抑制性免疫球蛋白值及甲状腺内淋巴细胞出现的意义

Significance of values of thyrotropin binding inhibitor immunoglobulins and appearance of intrathyroidal lymphocytes at subtotal thyroidectomy for Graves' disease.

作者信息

Kasuga Y, Sugenoya A, Kobayashi S, Shimizu T, Onuma H, Shingu K, Asanuma K, Hama Y, Iida F

机构信息

Department of Surgery, Shinshu University School of Medicine, Nagano, Japan.

出版信息

J Am Coll Surg. 1994 Jun;178(6):589-94.

PMID:7910771
Abstract

This study was undertaken to investigate whether thyrotropin binding inhibitor immunoglobulins (TBII) values at and after subtotal thyroidectomy correlated with the outcome or the histologic grade applied to the appearance of intrathyroidal lymphocytes at the time of surgical treatment. In addition, the main reason for the study was to determine whether or not it was possible to predict the outcome after the operation by the data obtained. There was no relation between the TBII results and the grade of the appearance of intrathyroidal lymphocytes at the time of operation or the TBII postoperative results (whether positive or negative) and the final outcome. However, it was of interest that patients with a recurrence of hyperthyroidism had the TBII values of more than 50 percent at the time of surgical treatment, and also manifested continuously positive TBII values after the operation. They also had moderate grades of lymphocytic infiltration and lymph follicle formation in the surgical specimen. It seemed impossible to predict the outcome of each instance in accordance with TBII values and the grade of the appearance of intrathyroidal lymphocytes at the time of the operation. However, it might be possible to predict at least the recurrence of hyperthyroidism by the consideration of changes of TBII values postoperatively.

摘要

本研究旨在探讨甲状腺次全切除术中及术后促甲状腺激素结合抑制性免疫球蛋白(TBII)值是否与手术治疗时甲状腺内淋巴细胞外观的结果或组织学分级相关。此外,该研究的主要目的是确定能否通过所获得的数据预测术后结果。TBII结果与手术时甲状腺内淋巴细胞外观分级之间、TBII术后结果(无论阳性或阴性)与最终结果之间均无关联。然而,有趣的是,甲状腺功能亢进复发的患者在手术治疗时TBII值超过50%,且术后TBII值持续呈阳性。他们的手术标本中还存在中度淋巴细胞浸润和淋巴滤泡形成。似乎无法根据手术时的TBII值和甲状腺内淋巴细胞外观分级来预测每个病例的结果。然而,通过考虑术后TBII值的变化,至少有可能预测甲状腺功能亢进的复发。

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