• 中國醫(yī)學(xué)科學(xué)院，中國協(xié)和醫(yī)科大學(xué)北京協(xié)和醫(yī)院普通外科（北京100730）;

目的 探討甲狀腺球蛋白（thyroglobulin，TG）在分化型甲狀腺癌（differentiated thyroid cancer，DTC）診斷和治療中的作用。
方法采用文獻(xiàn)回顧的方法，對血清TG的檢測方法及其在DTC診斷和術(shù)后隨診中的作用進(jìn)行綜述。
結(jié)果免疫測定法（immunometric assay,IMA）是臨床常用的檢測方法，檢測TG的同時應(yīng)檢測甲狀腺球蛋白抗體（TGAb）是否存在。手術(shù)前的TG水平對于診斷DTC的幫助不大，但對于區(qū)分DTC中不同病理類型有一定的幫助。在行甲狀腺全切除或近全切除+131I去除殘留腺體治療后的患者中，血清TG是隨診中非常重要的檢測指標(biāo)。檢測停用甲狀腺激素或在人重組TSH（recombinant human thyrotropin，rhTSH）刺激下的TG水平更能準(zhǔn)確反映疾病情況。
結(jié)論TG在甲狀腺全切除或近全切除+131I去除殘留腺體治療后患者的隨診中有很重要的作用。

引用本文： 李小毅. 甲狀腺球蛋白在分化型甲狀腺癌診治中的作用. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(3): 265-267. doi: 復(fù)制

1. [J]. J Clin Endocrinol Metab, 2005; 90(10)∶5566.
2. Endocrinol Metab Clin North Am, 1995; 24(4)∶841.
3. J Clin Endocrinol Metab, 1998; 83(4)∶1121.
4. J Clin Endocrinol Metab, 2004; 89(8)∶3702.
5. Clin Endocrinol (Oxf), 1979; 10(1)∶17.
6. Eur J Surg Oncol, 1998; 24(6)∶553.
7. Br J Cancer, 1988; 57(1)∶105.
8. J Endocrinol Invest, 1999; 22(11 Suppl)∶3.
9. Thyroid, 2000; 10(9)∶767.
10. J Clin Endocrinol Metab, 2003; 88(4)∶1433.
11. Serum thyroglobulin concentrations and (131)I wholebody scan results in patients with differentiated thyroid carcinoma after administration of recombinant human thyroidstimulating hormone [J].
12. J Nucl Med, 2001; 42(10)∶1470.
13. [J]. J Clin Endocrinol Metab, 2000; 85(1)∶175.
14. Clin Endocrinol (Oxf), 2004; 61(2)∶163.
15. J Clin Endocrinol Metab, 1999; 84(11)∶3877.
16. Endocr Relat Cancer, 2002; 9(4)∶227.
17. Br J Cancer, 2004; 91(2)∶200.
18. Refetoff S, Lever EG. The value of serum thyroglobulin measurement in clinical practice [J]. JAMA, 1983; 250(17)∶2352.
19. Girelli ME, De Vido D. Serum thyroglobulin measurements in differentiated thyroid cancer [J]. Biomed Pharmacother, 2000; 54(6)∶330.
20. Spencer CA, Takeuchi M, Kazarosyan M. Current status and performance goals for serum thyroglobulin assays [J]. Clin Chem, 1996; 42(1)∶164.
21. Spencer CA, Bergoglio LM, Kazarosyan M, et al. Clinical impact of thyroglobulin (TG) and TG autoantibody method differences on the management of patients with differentiated thyroid carcinomas.
22. Spencer CA, Wang CC. Thyroglobulin measurement. Techniques, clinical benefits, and pitfalls [J].
23. Spencer CA, Takeuchi M, Kazarosyan M, et al. Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement, and prognostic significance in patients with differentiated thyroid carcinoma [J].
24. Spencer CA. Challenges of serum thyroglobulin (TG) measurement in the presence of TG autoantibodies [J].
25. Shlossberg AH, Jacobson JC, Ibbertson HK.Serum thyroglobulin in the diagnosis and management of thyroid carcinoma [J].
26. Hocevar M, Auersperg M. Role of serum thyroglobulin in the preoperative evaluation of follicular thyroid tumours [J].
27. Thoresen SO, Myking O, Glattre E, et al. Serum thyroglobulin as a preclinical tumour marker in subgroups of thyroid cancer [J].
28. Schlumberger MJ. Diagnostic followup of welldifferentiated thyroid carcinoma: historical perspective and current status [J].
29. Mazzaferri EL, Kloos RT. Using recombinant human TSH in the management of welldifferentiated thyroid cancer: current strategies and future directions [J].
30. Mazzaferri EL, Robbins RJ, Spencer CA, et al. A consensus report of the role of serum thyroglobulin as a monitoring method for lowrisk patients with papillary thyroid carcinoma [J].
31. David A, Blotta A, Bondanelli M, et al.
32. Cailleux AF, Baudin E, Travagli JP, et al. Is diagnostic iodine131 scanning useful after total thyroid ablation for differentiated thyroid cancer?.
33. Woodmansee WW, Haugen BR. Uses for recombinant human TSH in patients with thyroid cancer and nodular goiter [J].
34. Haugen BR, Pacini F, Reiners C, et al. A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer [J].
35. Mazzaferri EL, Massoll N.Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin [J].
36. Verburg FA, Lips CJ, Lentjes EG, et al. Detection of circulating TGmRNA in the followup of papillary and follicular thyroid cancer: how useful is it? [J].
  1. 1. [J]. J Clin Endocrinol Metab, 2005; 90(10)∶5566.
  2. 2. Endocrinol Metab Clin North Am, 1995; 24(4)∶841.
  3. 3. J Clin Endocrinol Metab, 1998; 83(4)∶1121.
  4. 4. J Clin Endocrinol Metab, 2004; 89(8)∶3702.
  5. 5. Clin Endocrinol (Oxf), 1979; 10(1)∶17.
  6. 6. Eur J Surg Oncol, 1998; 24(6)∶553.
  7. 7. Br J Cancer, 1988; 57(1)∶105.
  8. 8. J Endocrinol Invest, 1999; 22(11 Suppl)∶3.
  9. 9. Thyroid, 2000; 10(9)∶767.
  10. 10. J Clin Endocrinol Metab, 2003; 88(4)∶1433.
  11. 11. Serum thyroglobulin concentrations and (131)I wholebody scan results in patients with differentiated thyroid carcinoma after administration of recombinant human thyroidstimulating hormone [J].
  12. 12. J Nucl Med, 2001; 42(10)∶1470.
  13. 13. [J]. J Clin Endocrinol Metab, 2000; 85(1)∶175.
  14. 14. Clin Endocrinol (Oxf), 2004; 61(2)∶163.
  15. 15. J Clin Endocrinol Metab, 1999; 84(11)∶3877.
  16. 16. Endocr Relat Cancer, 2002; 9(4)∶227.
  17. 17. Br J Cancer, 2004; 91(2)∶200.
  18. 18. Refetoff S, Lever EG. The value of serum thyroglobulin measurement in clinical practice [J]. JAMA, 1983; 250(17)∶2352.
  19. 19. Girelli ME, De Vido D. Serum thyroglobulin measurements in differentiated thyroid cancer [J]. Biomed Pharmacother, 2000; 54(6)∶330.
  20. 20. Spencer CA, Takeuchi M, Kazarosyan M. Current status and performance goals for serum thyroglobulin assays [J]. Clin Chem, 1996; 42(1)∶164.
  21. 21. Spencer CA, Bergoglio LM, Kazarosyan M, et al. Clinical impact of thyroglobulin (TG) and TG autoantibody method differences on the management of patients with differentiated thyroid carcinomas.
  22. 22. Spencer CA, Wang CC. Thyroglobulin measurement. Techniques, clinical benefits, and pitfalls [J].
  23. 23. Spencer CA, Takeuchi M, Kazarosyan M, et al. Serum thyroglobulin autoantibodies: prevalence, influence on serum thyroglobulin measurement, and prognostic significance in patients with differentiated thyroid carcinoma [J].
  24. 24. Spencer CA. Challenges of serum thyroglobulin (TG) measurement in the presence of TG autoantibodies [J].
  25. 25. Shlossberg AH, Jacobson JC, Ibbertson HK.Serum thyroglobulin in the diagnosis and management of thyroid carcinoma [J].
  26. 26. Hocevar M, Auersperg M. Role of serum thyroglobulin in the preoperative evaluation of follicular thyroid tumours [J].
  27. 27. Thoresen SO, Myking O, Glattre E, et al. Serum thyroglobulin as a preclinical tumour marker in subgroups of thyroid cancer [J].
  28. 28. Schlumberger MJ. Diagnostic followup of welldifferentiated thyroid carcinoma: historical perspective and current status [J].
  29. 29. Mazzaferri EL, Kloos RT. Using recombinant human TSH in the management of welldifferentiated thyroid cancer: current strategies and future directions [J].
  30. 30. Mazzaferri EL, Robbins RJ, Spencer CA, et al. A consensus report of the role of serum thyroglobulin as a monitoring method for lowrisk patients with papillary thyroid carcinoma [J].
  31. 31. David A, Blotta A, Bondanelli M, et al.
  32. 32. Cailleux AF, Baudin E, Travagli JP, et al. Is diagnostic iodine131 scanning useful after total thyroid ablation for differentiated thyroid cancer?.
  33. 33. Woodmansee WW, Haugen BR. Uses for recombinant human TSH in patients with thyroid cancer and nodular goiter [J].
  34. 34. Haugen BR, Pacini F, Reiners C, et al. A comparison of recombinant human thyrotropin and thyroid hormone withdrawal for the detection of thyroid remnant or cancer [J].
  35. 35. Mazzaferri EL, Massoll N.Management of papillary and follicular (differentiated) thyroid cancer: new paradigms using recombinant human thyrotropin [J].
  36. 36. Verburg FA, Lips CJ, Lentjes EG, et al. Detection of circulating TGmRNA in the followup of papillary and follicular thyroid cancer: how useful is it? [J].