摘要
目的探讨甲状腺乳头状癌患者在低剂量碘-131清除残留甲状腺组织(清甲)治疗前后,血清刺激性甲状腺球蛋白(stimulated thyroglobulin,sTg)和甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)水平及其变化趋势对清甲疗效的判断价值。方法选取2014年5月～2016年12月76例甲状腺乳头状癌患者行1.11GBq^(131)Ⅰ清甲治疗和碘-131全身及颈部断层显像,治疗前检测患者sTg-1和TgAb-1水平。第一次清甲治疗半年后复查sTg-2和TgAb-2水平,sTg-2>1μg/L患者再行1.11GBq^(131)Ⅰ清甲治疗和碘-131显像。第二次清甲治疗后半年,患者复查sTg和TgAb水平并行185 MBq碘-131显像判断清甲治疗疗效。以(sTg-2-sTg-1,△sTg)/sTg-1百分比值(%)代表sTg变化趋势,采用单因素方差分析或配对t检验比较转移组、清甲成功组及正常甲状腺残留组各组间sTg值及△sTg/sTg-1比值。结果两次清甲治疗后显像发现转移患者20例(26.32%,2例肺部转移,18例淋巴结转移);清甲成功率合计为83.93%(47/56);残留率合计为16.07%(9/56)。转移组sTg-1值均高于无转移组,差异有统计学意义(F=5.800,P<0.05)。第二次显像发现转移组sTg-2比sTg-1升高比例为55.56%(5/9);sTg-2降低患者中转移组的△sTg/sTg-1比值较未发现转移组低,差异有统计学意义(F=3.393,P<0.05)。结论血清sTg和TgAb水平在判断低剂量清甲治疗后是否存在转移或清甲是否成功有确切的临床应用价值。
Objective To investigate the levels and variation tendency of stimulated thyroglobulin （sTg） and thyroglobulin antibody （TgAb） before and after low-dose 131 I therapy in papillary thyroid carcinoma （PTC） , and monitor the predictive value of sTg for the efficacy of 131 I therapy. Methods From May 2014 to Dec 2016,a total of 76 PTC patients （28 males, 48 females）, average age （39.10＋-11.95） years, were received 1.11GBq 131 I therapy, and 131 I whole body and neck tomography imaging were performed, sTg-1 and TgAb-1 levels were measured before treatment, and sTg-2 and TgAb-2 levels were measured half a year later after first treatment. If sTg-2〉1 μg/L, patients were received 1.11GBq 131 I therapy again,and also 131 I whole body and neck tomography imaging were performed. Half a year later after second treatment, sTg3 and TgAL3 levels were measured, and 185 MBq 131 I whole body scan and neck tomography imaging were performed to evaluate treatment effect. （sTg-2 -sTg-1,△sTg）/sTg-1 defined as index of variation tendency. Results After the treatment of two times 131 I therapy, a total of 20 cases （26.32% ,including 2 patients with pulmonary metastasis and 18 patients with lymph node metastasis） of metastatic patients were detected by 131 I imaging. The rate of successful thyroid remnant ablation was 83. 93% （47/56 cases） ,and the residual rate was 16.07% （9/56）. The levels of sTg in metastasis group were high than non-metasta- sis groups,and there were statistical differences between these groups （F=5. 800, P〈0.05）. The increase ratio of sTg-2 value compared sTg-1 was 55.56 % （5/9） in metastasis group detected by the second time 131 I imaging. △sTg/sTg-1 values of patients in normal thyroid group with sTg-2 reduction was low than non-metastasis groups, and there were statistical differences between these groups （F=3. 393, P〈0.05）. Conclusion The levels of serum sTg and TgAb could be used in clinic to predict the efficacy of 131 I therapy in PTC patien
作者
何凯骅
章斌
陈志强
何杨
桑士标
HE Kai -hua, ZHANG Bin, CHEN Zhi -qiang, HE Yang,SANG Shi- biao(Department of Nuclear Medicine, the First Affiliated Hospital of Soochow University, Jiangsu Suzhou 215006, China; Jiangsu Blood Institute, Jiangsu Suzhou 215006, China)
出处
《现代检验医学杂志》
CAS
2018年第6期142-145,共4页
Journal of Modern Laboratory Medicine
