血清Tg值受干扰时监测TGAb水平变化对分化型甲状腺癌患者的临床意义

The Clinical Significance of Monitoring the Changes of TGAb Level in Patients with Differentiated Thyroid Cancer When Serum Tg Value Is False Negative

摘要: 甲状腺球蛋白(thyroglobulin, Tg)，是分化型甲状腺癌(differentiated thyroid carcinoma, DTC)患者治疗后进行随访的血清肿瘤标志物。但血清Tg值测定时会存在一定的干扰因素，Tg实验检测方法、甲状腺球蛋白抗体(thyroglobulin antibody, TgAb)等，都会导致假阴性/无法检测Tg值，则削弱了Tg对疾病的评估作用进而掩盖疾病。TGAb与DTC术后复发/转移有一定关联性，从而用于预测预后，但目前尚无定论，且存在争议。血清TgAb水平变化能否代替Tg作为肿瘤预测标记物已成为学者的研究热点，通过大量研究并得出普遍认可的结果，即TgAb可以作为新的肿瘤标志物用于DTC术后的随访监测。故研究假阴性/无法检测Tg值的DTC患者中血清TGAb水平变化，在Tg值受干扰时分析TGAb水平变化，对DTC疾病的价值意义进行综述。进而指导DTC患者术后随访及个体诊疗，从而为DTC患者术后的防治策略提供科学依据。

Abstract: Thyroglobulin (Tg), is a serum tumor marker in patients with differentiated thyroid cancer (DTC) followed up after treatment. However, there are some interference factors in the determination of serum Tg. Both the Tg experimental detection methods and thyroglobulin antibody (TgAb) lead to false negative/no Tg detection, which weakens the role of Tg in the evaluation of diseases and thus covers up diseases. TGAb has a certain correlation with postoperative recurrence/metastasis of DTC, so it can be used to predict prognosis, but there is still no conclusion and controversy. When serum TgAb monitoring is positive, whether Tg can replace Tg as a marker for tumor prediction has be-come a hot topic of scholars’ research. Through a large number of studies, it has been generally recognized that TgAb can be used as a new tumor marker for follow-up monitoring after DTC. Therefore, the change of serum TGAb level in DTC patients with false negative/undetectable Tg value was studied, and the value of the change in serum TGAb level in DTC diseases with inaccurate Tg value was analyzed and summarized, to guide the postoperative follow-up and individual diag-nosis and treatment of DTC patients, so as to provide a scientific basis for the postoperative preven-tion and treatment strategies of DTC patients.