van den Bergh J P, Pieters G F, Beex L V, Ross H A, Corstens F H, Smals A G
Afd. Endocriene Ziekten, Academisch Ziekenhuis, Nijmegen.
Ned Tijdschr Geneeskd. 1993 Jul 3;137(27):1344-8.
To determine whether it is reliable to do thyroglobulin measurements during thyroid hormone substitution (Tg ON) alone or whether it is also necessary to do 131I total body scanning (TBS) and Tg measurements after withdrawal of thyroid hormone substitution (Tg OFF) in the follow-up of patients with differentiated thyroid carcinoma.
Retrospective.
University Hospital Nijmegen.
202 Patients (151 females and 51 males, mean age 50.6 years) with differentiated thyroid carcinoma were examined in the period 1970-90. All patients had undergone total thyroidectomy and if necessary 131I ablation. 27 Patients with Tg antibodies were excluded (13.4%). In 175 patients Tg OFF levels were compared with TBS and clinical and radiological data. In 81 of them Tg ON levels were also compared.
Specificity of Tg OFF and Tg ON measurement was 83 and 88%. Sensitivity of Tg OFF and Tg ON measurement was 100 and 92%. In detecting local residual thyroid tissue Tg OFF was superior to Tg ON. In detecting metastases Tg OFF and Tg ON were both superior to TBS.
In the follow-up of patients with differentiated thyroid carcinoma it is reliable to do Tg measurements during thyroid hormone suppression. When Tg ON is detectable (> 3 pmol/l) TBS and Tg OFF measurement and if necessary further investigations have to be performed.
确定在分化型甲状腺癌患者随访中，仅在甲状腺激素替代治疗期间进行甲状腺球蛋白测量（Tg ON）是否可靠，还是在停用甲状腺激素替代治疗后进行131I全身扫描（TBS）和甲状腺球蛋白测量（Tg OFF）也有必要。
回顾性研究。
奈梅亨大学医院。
对1970年至1990年间的202例分化型甲状腺癌患者（151例女性和51例男性，平均年龄50.6岁）进行检查。所有患者均接受了甲状腺全切除术，必要时进行131I消融。排除27例有Tg抗体的患者（13.4%）。对175例患者的Tg OFF水平与TBS以及临床和放射学数据进行比较。其中81例患者还比较了Tg ON水平。
Tg OFF和Tg ON测量的特异性分别为83%和88%。Tg OFF和Tg ON测量的敏感性分别为100%和92%。在检测局部残留甲状腺组织方面，Tg OFF优于Tg ON。在检测转移灶方面，Tg OFF和Tg ON均优于TBS。
在分化型甲状腺癌患者的随访中，在甲状腺激素抑制期间进行Tg测量是可靠的。当检测到Tg ON（>3 pmol/l）时，需进行TBS和Tg OFF测量，必要时进行进一步检查。
