Valor da varredura com radioiodo em pacientes com carcinoma diferenciado de tireóide de moderado / alto risco com tireoglobulina (sem tiroxina) indetectável após o tratamento inicial

作者：Pedro Weslley Rosário, Ludmilla David Cardoso, Tales Alvarenga Fagundes, Janice Sepúlveda Reis, Frederico Fernandes Ribeiro Maia, Saulo Purisch · 发表于：Arquivos Brasileiros de Endocrinologia & Metabologia · 年份：2004 · DOI：10.1590/s0004-27302004000300009 · 被引用次数：3 · 研究领域：Thyroid Cancer Diagnosis and Treatment、Colorectal and Anal Carcinomas、Head and Neck Anomalies

We selected 92 patients without antithyroglobulin antibodies (TgAb), in whom thyroglobulin (Tg) after L-thyroxin withdrawal was undetectable (<1 ng/ml) 6-12 months after initial therapy and who were considered to be at moderate / high risk for recurrence by this criteria: age >45 years; tumor size >1.5 cm; and lymph nodes metastases in 43 (46.7%), local invasion in 26 (28.2%) or distant metastases in 23 (25%). Control whole-body scanning was negative in 78.2% of the cases and showed cervical uptake in the others. Cases presenting thyroid bed uptake in the absence of tumor recurrence did not receive radioiodine and Tg remained undetectable one year after the initial evaluation in all. Cervical uptake was not observed in 4/13 cases on repeated scan. In contrast, even in the absence of uptake and with undetectable Tg, 7 patients with recurrence confirmed by ultrasound (US) received surgical treatment. US showed 92.8% sensitivity for the detection of local-regional disease. The present study suggests that even moderate/high-risk patients without TgAb and with undetectable Tg levels (off T4) do not require radioiodine scanning after initial treatment and can be evaluated by cervical US.