血清TG和~（131）I-WBS在分化型甲状腺癌~（131）I清除甲状腺后的随访价值
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摘要
目的
探讨血清甲状腺球蛋白(thyroglobulin, TG)测定和131I全身扫描(131I-whole body scan, 131I-WBS)在分化型甲状腺癌(differentiated thyroid cancer, DTC)131I清除残余甲状腺后随访中的临床意义。
方法
选取暨南大学附属第一医院核医学科已接受甲状腺近全或全切除术并用131I清除残余甲状腺的分化型甲状腺癌患者64例,应用全自动化学发光免疫分析仪测定血清TG水平,采用单光子发射型计算机断层显像(single photon emission computed tomography, SPECT)进行131I-WBS。利用SPSS13.0分析软件进行数据分析,评估血清TG测定和131I-WBS在分化型甲状腺癌131I清除残余甲状腺后随访中的临床意义。
结果
64例DTC患者中,33例血清TG<2ng/m1(其中6例131I-WBS阳性)；10例2ng/ml＜TG＜10ng/ml(其中4例131I-WBS阳性)；21例血清TG>10ng/ml(其中19例131I-WBS阳性)。不同血清TG水平组间,甲癌复发或转移的发生率随TG水平升高而增加,组间比较具有显著意义(p<0.05)。其中血清TG阳性31例,灵敏度为80.6%,特异度为81.8%,准确度81.3%,阳性预测值80.6%,阴性预测值81.8%；而131I-WBS阳性29例,灵敏度为93.5%,特异度为100%,准确度96.9%,阳性预测值100%,阴性预测值94.3%；血清TG和131I-WBS联合检查,灵敏度为100%,特异度为81.8%,准确度90.6%,阳性预测值83.8%,阴性预测值100%。
结论
血清TG和131I-WBS在行甲状腺近全或全切除术并131I去除残留腺体治疗后的分化型甲状腺癌患者随诊中有重要的作用,二者联合,可相互补充。
Objective
To investigate the clinical value of serum thyroglobulin(TG) levels and 131I-whole body scan (131I-WBS) on the differentiated thyroid cancer (DTC) after 131I remnant ablation.
Methods
Blood samples were taken for measurement of serum TG levels by chemiluminescence and 131I-WBS were performed using a single photon emission computed tomography(SPECT) in 64 DTC patients who had received near-total/total thyroidectomy and radioactive iodine remnant ablation. SPSS 13.0 program were used to analyse the data to estimate the clinical value of serum TG levels and 131I-WBS on the DTC after 13II remnant ablation.
Results
In 64 patients with DTC, there were 33 patients who had serum TG concentrations< 2ng/ml (6 patients who have a positive 131I-WBS),10 patients who had serum TG concentrations of 2-10ng/ml (4 patients who have a positive 131I-WBS) and 21 patients who had serum TG concentrations>10ng/ml (19 patients who have a positive 131I-WBS). Among groups with different levels of serum TG, thyroid cancer recurrence or metastasis rate increased with TG elevation. There are significant differences in recurrence or metastasis rate between two groups (p<0.05). There are 31 patients whose TG>2ng/ml and 29 patients who have a positive 131I-WBS. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of measurements of TG in the detection of thyroid cancer recurrent or metastasis is 80.6%, 81.8%,81.3%,80.6% and 81.8% respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 131I-WBS in the detection of thyroid cancer recurrent or metastasis is 93.5%,100%,96.9%,100% and 94.3% respectively. After combining serum TG with 131I-WBS to detect thyroid cancer recurrent or metastasis, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value is 100%,81.8%, 90.6%,83.8%, and 100% respectively.
Conclusion
The serum TG and 131I-WBS play a major role in the DTC patients who had received near-total/total thyroidectomy and treated with 131I remnant ablation. The combination of serum TG and 131I-WBS has a higher diagnostic value than serum TG or 131I-WBS.
探讨血清甲状腺球蛋白(thyroglobulin, TG)测定和131I全身扫描(131I-whole body scan, 131I-WBS)在分化型甲状腺癌(differentiated thyroid cancer, DTC)131I清除残余甲状腺后随访中的临床意义。
方法
选取暨南大学附属第一医院核医学科已接受甲状腺近全或全切除术并用131I清除残余甲状腺的分化型甲状腺癌患者64例,应用全自动化学发光免疫分析仪测定血清TG水平,采用单光子发射型计算机断层显像(single photon emission computed tomography, SPECT)进行131I-WBS。利用SPSS13.0分析软件进行数据分析,评估血清TG测定和131I-WBS在分化型甲状腺癌131I清除残余甲状腺后随访中的临床意义。
结果
64例DTC患者中,33例血清TG<2ng/m1(其中6例131I-WBS阳性)；10例2ng/ml＜TG＜10ng/ml(其中4例131I-WBS阳性)；21例血清TG>10ng/ml(其中19例131I-WBS阳性)。不同血清TG水平组间,甲癌复发或转移的发生率随TG水平升高而增加,组间比较具有显著意义(p<0.05)。其中血清TG阳性31例,灵敏度为80.6%,特异度为81.8%,准确度81.3%,阳性预测值80.6%,阴性预测值81.8%；而131I-WBS阳性29例,灵敏度为93.5%,特异度为100%,准确度96.9%,阳性预测值100%,阴性预测值94.3%；血清TG和131I-WBS联合检查,灵敏度为100%,特异度为81.8%,准确度90.6%,阳性预测值83.8%,阴性预测值100%。
结论
血清TG和131I-WBS在行甲状腺近全或全切除术并131I去除残留腺体治疗后的分化型甲状腺癌患者随诊中有重要的作用,二者联合,可相互补充。
Objective
To investigate the clinical value of serum thyroglobulin(TG) levels and 131I-whole body scan (131I-WBS) on the differentiated thyroid cancer (DTC) after 131I remnant ablation.
Methods
Blood samples were taken for measurement of serum TG levels by chemiluminescence and 131I-WBS were performed using a single photon emission computed tomography(SPECT) in 64 DTC patients who had received near-total/total thyroidectomy and radioactive iodine remnant ablation. SPSS 13.0 program were used to analyse the data to estimate the clinical value of serum TG levels and 131I-WBS on the DTC after 13II remnant ablation.
Results
In 64 patients with DTC, there were 33 patients who had serum TG concentrations< 2ng/ml (6 patients who have a positive 131I-WBS),10 patients who had serum TG concentrations of 2-10ng/ml (4 patients who have a positive 131I-WBS) and 21 patients who had serum TG concentrations>10ng/ml (19 patients who have a positive 131I-WBS). Among groups with different levels of serum TG, thyroid cancer recurrence or metastasis rate increased with TG elevation. There are significant differences in recurrence or metastasis rate between two groups (p<0.05). There are 31 patients whose TG>2ng/ml and 29 patients who have a positive 131I-WBS. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of measurements of TG in the detection of thyroid cancer recurrent or metastasis is 80.6%, 81.8%,81.3%,80.6% and 81.8% respectively. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 131I-WBS in the detection of thyroid cancer recurrent or metastasis is 93.5%,100%,96.9%,100% and 94.3% respectively. After combining serum TG with 131I-WBS to detect thyroid cancer recurrent or metastasis, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value is 100%,81.8%, 90.6%,83.8%, and 100% respectively.
Conclusion
The serum TG and 131I-WBS play a major role in the DTC patients who had received near-total/total thyroidectomy and treated with 131I remnant ablation. The combination of serum TG and 131I-WBS has a higher diagnostic value than serum TG or 131I-WBS.
引文
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