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甲状腺癌是内分泌系统最常见的恶性肿瘤之一,占头颈部恶性肿瘤的5%~11%[1],在女性恶性肿瘤中位居第6位[2]。近年来甲状腺癌的发病率在发达国家显著升高[3]。甲状腺癌的病理类型主要为来源于甲状腺滤泡上皮细胞的DTC、未分化型甲状腺癌和来源于甲状腺滤泡旁细胞的髓样癌,其中DTC约占95%,包括乳头状癌(papillary thyroid carcinoma,PTC)、滤泡状癌(follicular thyroid carcinoma,FTC)及含有乳头状和滤泡状成分的混合癌。目前国内外推荐的DTC治疗方法为手术切除+131I核素治疗+TSH抑制治疗。DTC单纯手术切除后,复发率较高,约12%~19%发生远处转移,6%~21%出现局部复发,且复发多发生在术后5年内,少数患者在5年之后[4]。
目前血清甲状腺球蛋白(thyroglobulin,Tg)和131I全身扫描是DTC术后重要的随访指标,其中血清Tg水平的变化情况为术前是否发生初始远处转移提供理论参考,为术后是否存在残留甲状腺、转移灶或复发灶提供理论依据,血清甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)的存在可影响Tg的检测。因此,笔者主要综述血清Tg和TgAb在DTC诊治中的意义。
甲状腺球蛋白和甲状腺球蛋白抗体在分化型甲状腺癌诊治中的价值
The value of thyroglobulin and thyroglobulin antibody in the diagnosis and treatment of differentiated thyroid carcinoma
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摘要: 分化型甲状腺癌(DTC)是内分泌系统最常见的恶性肿瘤之一,且发病率逐年上升,目前其治疗手段主要是手术切除+131I核素治疗+促甲状腺激素抑制治疗。血清甲状腺球蛋白(Tg)是DTC的特异性肿瘤标志物,可为DTC的诊治、转移与复发的预测、疗效的评估提供依据。甲状腺球蛋白抗体(TgAb)的存在可影响Tg的测定。因此,笔者对Tg和TgAb在DTC诊治中的价值进行综述。Abstract: Differentiated thyroid carcinoma (DTC) is one of the most common malignant tumors of the endocrine system, and its incidence is increasing annually. At present, treatment methods for DTC primarily include surgical resection + 131I treatment + thyroid-stimulating hormone inhibition therapy. Serum thyroglobulin (Tg), as a specific tumor marker for DTC, can provide a basis for diagnosis and treatment of DTC, the prediction of its metastasis and recurrence, and the evaluation of treatment efficacy. The presence of Tg antibody (TgAb) may affect the determination of Tg. Therefore, this study reviews the role of serum Tg and TgAb in the diagnosis and treatment of DTC.
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Key words:
- Thyroglobulin /
- Thyroglobulin antibody /
- Differentiated thyroid cancer
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