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Objective To investigate the clinical significance of monitoring the serum levels of Thyroglobulin (Tg) and Thyroglobulin Autoantibody (TgAb) in the 131I ablation therapy for patients with differentiated thyroidcarcinoma (DTC).Methods 102 patients with DTC treated by 131I ablation therapy in our hospital from May 2014 to July 2016 were selected.The serum levels of Tg and TgAb were detected by radioimmunoassay before 131I ablation therapy,6 months after I 13 1I ablation therapy and 12 months after 131I ablation therapy.The body imaging were performed at seventh days after 1311 ablation therapy.Results The serum levels of Tg and TgAb at 6 months and 12 months after surgery were significantly lower than those before operation,and the difference were statistically significant (t =9.260,17.507,2.534,4.797,P ＜ 0.05).The serum levels of Tg and TgAb in metastasis group were higher than that in non-metastasis group (t =10.257,7.353,P ＜0.05).The serum levels of Tg and TgAb in the effective group were lower than those in the ineffective group,and the difference were statistically significant (t =7.325,4.978,P ＜ 0.05).The positive rate of Tg combined with TgAb was similar with 131I-WBS screening methods and the difference was not statistically significant (P ＞ 0.05).The positive rate of Tg screening method and the positive rate of TgAb were higher than that of 131I-WBS screening method,but the difference was not statistically significant (P ＞ 0.05).Conclusions The level of serum Tg and TgAb is an important reference index for the efficacy,metastasis and recurrence of DTC after operation,and Tg combined with TgAb has a higher accuracy in the screening prognosis of DTC after operation.
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Regarding radioactive iodine-refractory failure or advanced differentiated thyroid cancer,multiple multikinase inhibitors including sorafenib and lenvatinib,which target platelet derived growth factor receptor,vascular endothelial growth factor pathway,and rearranged during transfection (RET) pathway were proved to have obvious antitumor activity.Moreover,selective BRAF inhibitor,promoting drug uptake of radioactive iodine also showed a certain therapeutic effect.These molecular targets which are relevant with differentiated thyroid cancer occurrence,development,invasion and metastasis have become of its moment,and,selective inhibitors and re-differentiation agents were shown to be promising.In the future,individual genetic testing would provide more specific information in directing individualized molecular-targeted therapy.
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The incidence of differentiated thyroid carcinoma ( DTC) has increased in all age groups worldwide. Most patients with DTC have a good prognosis, but older patients have a poor prognosis because of high invasiveness and disease-specific mortality. At present, DTC treatment mainly includes surgery, thy-roid stimulating hormone ( TSH) inhibition , radioiodine ( 131 I) , external radiotherapy, and kinase inhibi-tors ( KIs) . Elderly patients with thyroid cancer might have many treatment-related complications due to dis-ease and their own reasons. This review uses the risk-benefit approach to weigh the pros and cons of various treatments to determine the most reasonable management.
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Objective To study the approach to improving the diagnosis and treatment of thyroid cancer(TC). Methods Problems regarding to the diagnosis and treatment of TC had arisen based on the combination of auther's clinical experience and recent literatures review. Results and Conclusions (1) In the diagnosis of TC, attention should be paid to the following conditions: cystocarcinoma, multicentral cancer, bilateral TC, coexist of benign thyroid diseases with TC, and the microcancer of thyroid etc. (2) Biopsy should be done during and after operation for the thyroid nodule needed to be operated, to avoid misdiagnosis of TC. (3) Except undifferentiated carcinoma, the choice of treatment of TC is surgery. The choice of operative procedure should be according to the pathological type and clinical stage of TC, and patient's condition. (4) Thyroid hormone suppression therapy should be administrated after operation. (5) Posterative radiotherapy can promote the long term survival rate. (6) Reoperation should be performed immediately, if the thyroid nodule is TC and comfired by pathological examination posteratively, and a subtotal thyroidectomy or nodule local resection performed on for that nodule initially, to avoid the residual cancer and cancer recurrence in the residual thyroid tissues.