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目的探讨血清甲状腺球蛋白(thyroglobulin,Tg)测定和131I-全身扫描(131I-wholebody scan,WBS)在分化型甲状腺癌(differentiated thyroid carcinoma,DTC)患者131I治疗随访中的意义。方法于首次治疗前,治疗后第5d、3个月,对我科进行131I治疗的56例DTC患者进行血清Tg测定和131I-WBS。结果 131I治疗前,131I-WBS显示51例残留甲状腺或转移灶,其血清Tg均>11mg/L;余5例未发现复发或转移,4例血清Tg<11mg/L,1例血清Tg>11mg/L。131I治疗后第5d,3例发现浓聚131I转移灶较治疗前增多。131I治疗后3个月,33例131I-WBS显像未见颈部存在明显的131I摄取,而且未见任何其他部位的异常131I摄取灶,Tg<11mg/L;18例131I-WBS显像见颈部存在明显的131I摄取,但未见任何其他部位的异常131I摄取灶,15例Tg>11mg/L,3例Tg<11mg/L,未见明显升高;5例131I-WBS显像见明显异常131I摄取病灶;Tg>11mg/L。结论 131I-WBS联合血清Tg测定在131I治疗DTC随访中具有重要的作用,可提高转移灶的检出率。
Objective To investigate the significance of serum thyroglobulin (Tg) and 131I-whole body scan (WBS) in the follow-up of 131I in patients with differentiated thyroid carcinoma (DTC). Methods The serum Tg and 131I-WBS were measured in 56 DTC patients treated with 131I before the first treatment, 5d and 3 months after treatment. Results Before 131I treatment, 131I-WBS showed 51 cases of residual thyroid or metastasis with serum Tg> 11mg / L. No recurrence or metastasis was found in 5 cases, serum Tg <11mg / L, serum Tg> 11mg / L. On the 5th day after 131I treatment, 3 cases showed that 131I metastasis increased compared with that before treatment. Three months after 131I treatment, there was no significant 131I uptake in the neck of 33 cases of 131I-WBS imaging, and no abnormal 131I uptake was seen in any other site, with Tg <11mg / L; in 18 cases of 131I-WBS imaging There was a significant 131I uptake in the neck but no abnormal 131I uptake was seen in any of the other sites, 15 with Tg> 11 mg / L, 3 with Tg <11 mg / L and no significant increase, and 5 with 131I-WBS imaging Significant abnormal 131I uptake lesions; Tg> 11mg / L. Conclusion 131I-WBS combined with serum Tg measurement plays an important role in the follow-up of 131I-treated DTC, which can improve the detection rate of metastases.