Diferansiye tiroid karsinomlarında ablasyon kontrolü sırasında ortaya Çıkan 5 Mci iyot-131 sintigrafisi negatif, tiroglobulin pozitif uyumsuzluğunun değerlendirilmesi

Evaluation of discordance in differentiated thyroid cancer patients with negative radioiodine scans and positive thyroglobulin values at the ablation outcome control

Halim İŞSEVER, Zeynep Gözde ÖZKAN, Cüneyt TÜRKMEN, Yeşim ERBİL, Işık ADALET, Harika BOZTEPE, Neşe ÇOLAK, Ferihan ARA

Abstract

Objective: We aimed to evaluate the discordance of 5 mCi (185 MBq) I-131 whole body scan (WBS) and thyroglobulin (Tg) values at the ablation outcome control in differentiated thyroid cancer (DTC) patients who had thyroidectomy and then received radioiodine (RAI) ablation. Materials and Methods: We retrospectively evaluated 36 DTC patients who had RAI treatment in our department between 1992-2009 and whose 5 mCi (185 MBq) I-131 WBS were negative, but Tg values were ≥2 ng/ml during the ablation outcome control (Patient group). Thirty-six patients whose Tg values were < 2 ng/ml and showed no discordance at the same control made up the control group. Patient and control groups were compared in terms of age, gender, histopathological features, ablation dose, Tg value before ablation, and 24. hour RAI uptake value during ablation. The patient group was then evaluated for the cause of the discordance.Results: There were 28 female and 8 male patients whose mean age was 45.6±11.39 in patient group. In the control group, there were 29 female and 7 male patients whose mean age was 41.5±11.69. According to the reason of discordance at the ablation outcome control, the patient group was divided into 2 groups: 15 (42%) patients (9 female, 6 male patients, mean age: 50.66±10.73) who had metastatic lymph nodes as the reason of discordance constituted the lymph node group. The remaining 21 (58%) patients (19 female, 2 male patients, mean age: 41.5±10.44) were the micrometastatic group in which the cause of discordance could not be determined. There were statistically significant differences in soft tissue invasion (p

Özet

Amaç: Diferansiye tiroid karsinomu (DTK) hastalarında, ablasyon kontrolü sırasında ortaya çıkan 5 mCi İyot-131 tüm vücut sintigrafisi ve tiroglobülin değeri uyumsuzluğunu ve bunun olası nedenlerini incelemeyi amaçladık.Hastalar ve Yöntemler: DTK tanılı hastalarda ablasyon kontrolü için yapılan 5 mCi TVS (-) ve Tg değeri ≥2ng/ml olan 36 hasta retrospektif olarak incelendi(hasta grubu). Tg değerleri 2cm açısından anlamlı fark bulundu. Hasta grubundaki değerlendirmede ise, E cinsiyet, tümör çapı>2cm, tiroid kapsül invazyonu ve yaş>40 gibi parametrelerin karşılaştırılmasında lenf nodu ve mikrometastatik grup arasında anlamlı fark bulundu.Sonuç: Ablasyon kontrolü sırasında ortaya çıkan 5 mCi-TVS (-), Tg (+) uyumsuzluğunda tespit edilebilen başlıca neden lenf nodu metastazıdır.