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目的探讨在分化型甲状腺癌(DTC)患者清除甲状腺后随访中,测定血清甲状腺球蛋白(Tg)和131I全身显像(WBS)的临床价值。方法选择96例在湖北省襄阳市中心医院行甲状腺全切或部分切除术,后经131I去除残余甲状腺的DTC患者,口服诊断剂量131I后进行全身显像,并采用放射免疫分析(RIA)法测定血清Tg含量。结果 96例患者中经临床确诊复发或转移48例,其中Tg≤2ng/mL 9例(18.37%);Tg在2～10ng/mL 7例(46.67%);Tg≥10ng/mL 32例(100.00%),组间比较差异有统计学意义(P<0.05)。血清Tg和131I-WBS联合检测,灵敏度为100.0%,特异性为84.2%,准确度为90.5%,阳性预测值87.9%,阴性预测值为100.0%。结论血清Tg和131I-WBS是DTC术后随访的重要参考指标,联合检测对判断DTC术后是否转移或复发有重要监测价值。
Objective To investigate the clinical value of serum thyroglobulin (Tg) and 131I whole body scintigraphy (WBS) in the follow-up of patients with differentiated thyroid carcinoma (DTC). Methods Ninety-six patients with DTC who had undergone thyroidectomy or partial thyroidectomy in Xiangyang Central Hospital of Hubei Province were treated with 131I to remove residual thyroid gland. After the diagnostic dose of 131I was orally administered, whole body imaging was performed and radioimmunoassay (RIA) Serum Tg content. Results Among the 96 patients, 48 cases were diagnosed as having relapsed or metastasized clinically, among which Tg was ≤2ng / mL in 9 cases (18.37%); Tg was 2-10ng / mL in 7 cases (46.67%); Tg≥10ng / %), The difference between the groups was statistically significant (P <0.05). The combined detection of serum Tg and 131I-WBS showed a sensitivity of 100.0%, a specificity of 84.2%, an accuracy of 90.5%, a positive predictive value of 87.9% and a negative predictive value of 100.0%. Conclusions Serum Tg and 131I-WBS are important reference indexes for DTC postoperative follow-up. The combined detection is of great value in judging whether DTC is metastasis or recurrence.