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目的:探讨分化型甲状腺癌(differentiated thyroid cancer,DTC)首次131I清甲治疗半年后甲状腺球蛋白(thyroglobulin,Tg)阴性但甲状腺床仍有少量残留的患者是否需要再次131I治疗。方法:甲状腺全切或近全切术后行131I治疗且TGAb正常者72例,按首次131I治疗后有无甲状腺床残留分为残留组27例,对照组45例,分别随访动态监测Tg、TGAb及131I显像。结果:残留组与对照组随访前后Tg均无显著变化;残留组(t=0.970,P>0.05),对照组(t=0.800,P>0.05)。首次随访残留组与对照组Tg无显著差别(t=0.43,P>0.05),随访末残留组与对照组Tg仍无明显差异(t=0.846,P>0.05)。结论:甲状腺全切或近全切除术后行131I治疗的分化型甲状腺癌患者,首次随访Tg<2μg/L但甲状腺床有少量残留时,无需再次碘治疗。
OBJECTIVE: To investigate whether 131I treatment is needed in patients with differentiated thyroid cancer (DTC) after 131I treatment for the first time with negative thyroglobulin (Tg) but still with a small residual thyroid gland. Methods: Thirty-two cases of 131I treatment and TGAb normalization after total or near total thyroidectomy were divided into residual group (n = 27) and control group (n = 45) according to the first 131I treatment. And 131I imaging. Results: There was no significant difference in Tg between the residual group and the control group before and after follow-up. The residual group (t = 0.970, P> 0.05) and the control group (t = 0.800, P> 0.05). There was no significant difference between the residual group and the control group at the first follow-up (t = 0.43, P> 0.05). There was no significant difference between the residual group and the control group at the end of follow-up (t = 0.846, P> 0.05). CONCLUSION: Patients with differentiated thyroid cancer treated with 131I after total or near total thyroidectomy have a first follow-up of Tg <2 μg / L but no residual iodine treatment is required when there is a small amount of residual thyroid bed.