Is 131I ablation necessary for patients with low-risk papillary thyroid carcinoma and slightly elevated stimulated thyroglobulin after thyroidectomy?

ABSTRACT Objective This prospective study evaluated the recurrence rate in low-risk patients with papillary thyroid cancer (PTC) who presented slightly elevated thyroglobulin (Tg) after thyroidectomy and who did not undergo ablation with131I. Subjects and methods The study included 53 low-risk patients (nonaggressive histology; pT1b-3, cN0pNx, M0) with slightly elevated Tg after thyroidectomy (> 1 ng/mL, but ≤ 5 ng/mL after levothyroxine withdrawal or ≤ 2 ng/mL after recombinant human TSH). Results The time of follow-up ranged from 36 to 96 months. Lymph node metastases were detected in only one patient (1.9%). Fifty-two patients continued to present negative neck ultrasound. None of these patients without apparent disease presented an increase in Tg. Conclusions Low-risk patients with PTC who present slightly elevated Tg after thyroidectomy do not require ablation with 131I.

摘要
研究目的：本前瞻性研究评估了甲状腺乳头状癌（PTC）低危患者在甲状腺切除术后出现轻度甲状腺球蛋白（Tg）升高，且未接受¹³¹I清甲治疗的复发率。
研究对象与方法：本研究纳入53例甲状腺切除术后出现轻度Tg升高的低危患者，其组织学非侵袭性，TNM分期为pT1b~3、cN0pNx、M0；患者Tg水平在左甲状腺素停药后>1 ng/mL且≤5 ng/mL，或经重组人促甲状腺激素（TSH）刺激后≤2 ng/mL。
研究结果：随访时长为36~96个月。仅1例患者（1.9%）检出淋巴结转移。52例患者的颈部超声检查结果持续为阴性，此类无明确病灶者均未出现Tg水平升高。
研究结论：甲状腺乳头状癌低危患者在甲状腺切除术后出现轻度Tg升高者，无需接受¹³¹I清甲治疗。