CAJ | 학술논문

诊断性全身显像(Dx-WBS)和Tg测定是判断DTC患者131I清除术后残留甲状腺(简称清甲)是否成功的主要手段.部分治疗后患者出现Tg阴性和Dx-WBS甲状腺床阳性(Tg-/Dx-WBS+),目前这一结果的临床意义不明朗.残留甲状腺正常组织或癌灶过小、NIS基因表达增强、甲状腺组织内炎性病灶可能是导致Tg-/Dx-WBS+的原因.对清甲后Tg-/Dx-WBS+的患者,进行随访观察而不立即治疗是更合理的选择.
진단성전신현상(Dx-WBS)화Tg측정시판단DTC환자131I청제술후잔류갑상선(간칭청갑)시부성공적주요수단.부분치료후환자출현Tg음성화Dx-WBS갑상선상양성(Tg-/Dx-WBS+),목전저일결과적림상의의불명랑.잔류갑상선정상조직혹암조과소、NIS기인표체증강、갑상선조직내염성병조가능시도치Tg-/Dx-WBS+적원인.대청갑후Tg-/Dx-WBS+적환자,진행수방관찰이불립즉치료시경합리적선택.
Diagnostic whole body scan (Dx-WBS) with 131I and serum Tg level are the main parameters to evaluate the effectiveness of thyroid remnant ablation in patients with DTC.Undetectable Tg and positive radioiodine uptake in the thyroid bed (Tg-/Dx-WBS+) may be found in some patients.However,the clinical significance is uncertain.A small amount of thyroidal remnant,a small DTC lesion,increased expression of NIS gene and autoimmune inflammation may all result in Tg-/Dx-WBS+.A "wait-and-watch" approach without rushing for high-dose radioiodine treatment might be a more reasonable approach for these patients.