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【medical-news】哪类甲状腺癌患者需要定期刺激试
Authors: Zanotti-Fregonara, Paolo; Khoury, Alexandre; Duron, Françoise; Keller, Isabelle; Christin-Maître, Sophie; Kiffel, Thierry; Toubert, Marie; Devaux, Jean-Yves; Hindié, Elif1
Source: European Journal of Nuclear Medicine and Molecular Imaging, Volume 34, Number 4, April 2007, pp. 541-546
Publisher: Springer
Abstract:
Recurrences are frequent in thyroid cancer patients and long-term follow-up is therefore necessary. We evaluated the yield of rhTSH stimulation in three groups of patients, classified according to the UICC/TNM risk stratification and the results of first follow-up testing.
The study population comprised 129 patients referred for rhTSH testing. All had undergone first follow-up testing after thyroid hormone withdrawal (off-T4) within 1 year of 131I ablation. Negative first follow-up testing was defined as Tg <2 ng/ml and no neck uptake on 131I diagnostic whole-body scan. Seventy-five patients had stage I thyroid cancer and negative first follow-up testing (group A), 19 had stage I disease and positive first follow-up testing (group , and 35 had stage II-IV disease (group C). RhTSH stimulation was performed an average of 6 years after first follow-up testing.
131I diagnostic scanning after rhTSH was negative in all 75 group A patients. Only one group A patient had detectable Tg after rhTSH injection (1.5 ng/ml), but Tg had also been detected at baseline in this patient (1.45 ng/ml). Given the absence of a response to stimulation, suggesting an interference, Tg was reassessed with a different technique and proved to be undetectable (<0.1 ng/ml). Stimulation with rhTSH in group B showed residual Tg in seven patients and residual 131I uptake in the thyroid bed in two patients, but none of these patients had signs of disease progression. Five group C patients (14%) had a positive rhTSH test result, and this was suggestive of disease progression in at least two cases.
The first follow-up testing is essential for prognostic classification after 131I ablation of thyroid cancer. In stage I patients, undetectable Tg and negative 131I scan 1 year after ablation define a large population of subjects who have a very low risk of recurrence and who do not require further stimulation tests. In contrast, periodic rhTSH stimulation tests appear useful in higher-risk patients. 本人认领此文。如在48小时内未能提交译文，其他战友可自由认领。 TITLE:Which thyroid cancer patients need periodic stimulation tests?
题目：那类甲状腺癌患者需要定期刺激试验？
Authors: Zanotti-Fregonara, Paolo; Khoury, Alexandre; Duron, Françoise; Keller,
Isabelle; Christin-Maître, Sophie; Kiffel, Thierry; Toubert, Marie; Devaux, Jean-
Yves; Hindié, Elif1
作者： Zanotti-Fregonara, Paolo; Khoury, Alexandre; Duron, Françoise; Keller,
Isabelle; Christin-Maître, Sophie; Kiffel, Thierry; Toubert, Marie; Devaux, Jean-
Yves; Hindié, Elif1
Abstract:
Recurrences are frequent in thyroid cancer patients and long-term follow-up is
therefore necessary. We evaluated the yield of rhTSH stimulation in three groups of
patients, classified according to the UICC/TNM risk stratification and the results
of first follow-up testing.
The study population comprised 129 patients referred for rhTSH testing. All had
undergone first follow-up testing after thyroid hormone withdrawal (off-T4) within
1 year of 131I ablation. Negative first follow-up testing was defined as Tg <2
ng/ml and no neck uptake on 131I diagnostic whole-body scan. Seventy-five patients
had stage I thyroid cancer and negative first follow-up testing (group A), 19 had
stage I disease and positive first follow-up testing (group , and 35 had stage II-
IV disease (group C). RhTSH stimulation was performed an average of 6 years after
first follow-up testing.
131I diagnostic scanning after rhTSH was negative in all 75 group A patients. Only
one group A patient had detectable Tg after rhTSH injection (1.5 ng/ml), but Tg had
also been detected at baseline in this patient (1.45 ng/ml). Given the absence of a
response to stimulation, suggesting an interference, Tg was reassessed with a
different technique and proved to be undetectable (<0.1 ng/ml). Stimulation with
rhTSH in group B showed residual Tg in seven patients and residual 131I uptake in
the thyroid bed in two patients, but none of these patients had signs of disease
progression. Five group C patients (14%) had a positive rhTSH test result, and this
was suggestive of disease progression in at least two cases.
The first follow-up testing is essential for prognostic classification after 131I
ablation of thyroid cancer. In stage I patients, undetectable Tg and negative 131I
scan 1 year after ablation define a large population of subjects who have a very
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作者:admin@医学,生命科学 2011-07-21 07:26
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