医学
左旋甲状腺素
甲状腺癌
甲状腺球蛋白
甲状腺癌
人口
内科学
甲状腺
肿瘤科
内分泌学
环境卫生
作者
Martin Schlumberger,Gertrud G Berg,Ohad Cohen,Leonidas H. Duntas,François Jamar,Barbara Jarząb,Eduard Limbert,Peter Lind,Furio Pacini,Christoph Reiners,Franco Sanchez Franco,A. D. Toft,Wilmar M. Wiersinga
出处
期刊:European journal of endocrinology
[Bioscientifica]
日期:2004-02-01
卷期号:150 (2): 105-112
被引量:307
标识
DOI:10.1530/eje.0.1500105
摘要
Because differentiated (follicular and papillary) thyroid cancer (DTC) may recur years after initial treatment, the follow-up of patients with DTC is long term. However, this population has changed, with more individuals being discovered at an earlier stage of the disease, so that previous follow-up protocols based mostly on data from high-risk patients no longer apply. We sought to develop an improved protocol for the follow-up of low-risk patients with DTC based on the findings of recent studies.We analysed recent literature on the follow-up of DTC.Recent large studies have produced three important findings: (i) in patients with low-risk DTC with no evidence of disease up to the 6- to 12-month follow-up, diagnostic whole-body scan adds no information when serum thyroglobulin (Tg) is undetectable and interference from anti-Tg antibodies is absent; (ii) use of recombinant human thyroid-stimulating hormone to aid Tg measurement is effective and provides greater safety, quality-of-life and work productivity than does levothyroxine withdrawal with its attendant hypothyroidism; and (iii) ultrasonography performed by an experienced operator is the most sensitive means of detecting neck recurrences of DTC.We present a revised follow-up protocol for low-risk patients taking into account the above findings. This protocol should help clinicians enter a new era of monitoring characterized by greater safety, simplicity, convenience and cost savings.
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