The significance of serum stimulating thyrogloblin level in monitoring and diagnosis of differeniated thyroid carcinoma metastasis / 中华放射医学与防护杂志

ABSTRACT

Objective To investigate the clinical significance of postoperative stimulated thyroglobulin ( ps-Tg) detection in the patients with differentiated thyroid carcinoma ( DTC) 131 I therapy. Methods Totally 73 cases with DTC who were hospitalized from March 2009 to March 2018 with complete treatment and follow-up data were selected as the study subjects. The cases were divided into three groups by 131I scanning image, no metastasis group (32 cases), lymph node metastasis group (31 cases), and distance metastasis group ( 10 cases ) . The levels of stimulated thyroglobulin ( s-Tg ) in serum were detected within one week before 131 I ablation for thyroid remnant and metastasis after surgical treatment. The 131I -whole body scan (131I -WBS) was performed at 3 to 5 days after 131I treatment and these cases were followed-up for 8-12 months. Results There was not statistically significant difference in ps-Tg between no metastasis group and lymph node metastasis group before 131I treatment(P>0.05). The ps-Tg in distance metastasis group was significantly higher than that in patients without metastasis and lymph node metastasis(Z= -3.810、 Z= -3.371, P<0.05). Before treatment with 131I ablation metastasis, there was not statistically difference in s-Tg among 3 groups(H=11.764, P<0.05). The area under the ROC curve of ps-Tg and s-TG diagnostic DTC distant metastasis rate before treatment of ablation for thyroid remnant was 0.903, and the accuracy were 90.48％. The area under the ROC curve of diagnosis of DTC distant metastasis and lymph node metastasis before ablation for thyroid metastasis was 0. 817 and 0.644, and the accuracy was 88.10％ and 65.08％, respectively. Conclusions The accuracy of diagnosing DTC distant metastasis of ps-Tg before 131 I ablation for thyroid remnant is superior to ps-Tg before ablation forthyroid metastasis. The level of s-Tg diagnosis of DTC lymph node before 131 I ablation metastasis precede ps-Tg before 131 I ablation for thyroid remnant