Sophocleous S, Ehrenheim C, Fischer J, Hundeshagen H
Abteilung Nuklearmedizin und spezielle Biophysik, Medizinischen Hochschule Hannover, Deutschland.
Nuklearmedizin. 1997 Apr;36(3):93-102.
A retrospective study was performed to determine the frequency of local recurrences and distant metastases as well as potential risk factors in patients with low-risk differentiated thyroid carcinoma. In addition, the efficiency of our follow-up programme and the diagnostic value of the procedures administered was to be evaluated.
41/740 (8%) patients developed 62 recurrences at a mean 4.7 years after the onset of the disease. In 14 cases the tumor marker thyroglobulin was the first diagnostic sign. 13 recurrences were diagnosed by chest x-ray and/or CT. In 12 cases recurrences/metastases were detected by iodine-131 whole body scan, and 8 cases by ultrasound of the neck. A good prognosis was found if patients were under 45 years of age when the tumor was first diagnosed, and if the tumor did not exceed 20 mm in diameter. The prognosis was not statistically significant influenced by histology, gender and surgical methods. The 10-year survival rate for papillary carcinomas was 91% and for follicular carcinomas 84%.
We recommend yearly follow-up examinations with selective use of other diagnostic methods in order to provide best patient care.
开展一项回顾性研究，以确定低危分化型甲状腺癌患者局部复发和远处转移的频率以及潜在风险因素。此外，还要评估我们随访计划的有效性以及所采用检查方法的诊断价值。
740例患者中有41例（8%）在疾病发病后平均4.7年出现了62次复发。14例中肿瘤标志物甲状腺球蛋白是首个诊断迹象。13次复发通过胸部X线和/或CT诊断出来。12例复发/转移通过碘-131全身扫描检测到，8例通过颈部超声检测到。如果患者首次诊断出肿瘤时年龄在45岁以下且肿瘤直径不超过20毫米，则预后良好。组织学、性别和手术方法对预后无统计学显著影响。乳头状癌的10年生存率为91%，滤泡状癌为84%。
我们建议每年进行随访检查并选择性地使用其他诊断方法，以便为患者提供最佳护理。
