Zusammenfassung
Thyreoglobulin (hTg) bzw. Kalzitonin (hCt) sind etablierte humorale Tumormarker für
die Therapieüberwachung und Nachsorge der behandelten thyreoidalen Follikelzell- bzw.
C-Zell-Karzinome. Hierfür besitzen diese Analyten eine im Vergleich zu vielen anderen
Tumormarkern hohe diagnostische Spezifität, die mit dem Ausmaß der Radikalität der
Schilddrüsenablation zunimmt. In den letzten Jahren werden Assays mit zunehmender
funktioneller Sensitivität angeboten, die allerdings mit neuen Herausforderungen an
die labortechnische Durchführung, die Qualitätssicherung sowie die Interpretation
der im „ultrasensitiven” Bereich messbaren Werte einhergehen. Ohnehin sind hTg und
hCt als relativ anspruchsvolle Laborparameter anzusehen. Die Messergebnisse sind zum
Teil deutlich abhängig von diversen In-vivo- und In-vitro-Einflussfaktoren, aber auch
bei konstanten Rahmenbedingungen ist die Vergleichbarkeit der gemessenen Werte zwischen
verschiedenen Assays nicht ohne weiteres garantiert. Hinsichtlich der hCt-Bestimmung
bieten Assays mit weitgehend selektiver Erfassung der monomeren (reifen) Kalzitoninform
den Vorteil einer weiteren Steigerung der diagnostischen Spezifität. Abgesehen von
der Überwachung der wegen eines Schilddrüsenkarzinom behandelten Patienten wird die
hCt-Bestimmung von zahlreichen Fachgesellschaften auch bei der Dignitätsabklärung
thyreoidaler Raumforderungen als gerechtfertigt angesehen, wohingegen die hTg-Bestimmung
nicht als Routinemaßnahme zur Schilddrüsenknotenabklärung in die Leitlinien aufgenommen
wurde. Die hTg-Bestimmung kann aber bei der Evaluierung bestimmter benigner Schilddrüsenprozesse
indiziert sein wie der Differenzialdiagnose der konnatalen Hypothyreose, der Abklärung
einer vermuteten faktitiellen Hyperthyreose oder als Aktivitätsmarker für destruierende
Schilddrüsenprozesse wie der subakuten oder Amiodaron-induzierten Thyreoiditis.
Abstract
Thyroglobulin and calcitonin are established humoral tumor markers for therapy monitoring
and follow up of thyroid cancer of follicular origin or medullary thyroid cancer,
respectively. In comparison to many other tumor markers these analytes offer a high
diagnostic specificity, which increases with the radicalness of thyroid ablation.
Over the last years, assays with rising functional sensitivity became commercially
available, being however a challenge in respect to laboratory performance, quality
assurance and medical judgement in the „ultrasensitive” range of detectable concentrations.
Anyway, hTg and hCT must be considered to be ambitious laboratory parameters. The
results considerably depend on various in vivo and in vitro influences, and even under
constant conditions, different assays may not necessarily produce identical results.
hCt assays that measure the monomer (mature) calcitonin form have the advantage of
an enhancement of the diagnostic specificity. Apart from follow up investigations
in treated MTC patients, a couple of medical societies assume hCt measurement to be
justified in the presence of a thyroid nodule. In contrast, guidelines do not recommend
hTg measurement as a routine procedure for the assessment of the malignancy of thyroid
nodules. However, hTg measurement may have an indication in differential diagnosis
of connatal hypothyroidism, in assumed thyrotoxicosis factitia and as a marker of
destructive thyroidal disease like subacute or amiodarone-induced thyroiditis.
Schlüsselwörter
Thyreoglobulin (hTg) - Kalzitonin (hCt) - differenziertes Schilddrüsenkarzinom - medulläres
Schilddrüsenkarzinom - Nachsorge - Schilddrüsenknoten
Key words
thyroglobulin (hTg) - calcitonin (hCt) - differentiated thyroid cancer - medullary
thyroid cancer - restaging - thyroid nodule
Literatur
- 1
Baloch Z, Carayon P, Conte-Devolx B. et al .
Guidelines Committee, National Academy of Clinical Biochemistry. Laboratory medicine
practice guidelines. Laboratory support for the diagnosis and monitoring of thyroid
disease.
Thyroid.
2003;
13
3-126
- 2
Bieglmayer C, Vierhapper H, Dudczak. et al .
Measurement of calcitonin by immunoassay analyzers.
Clin Chem Lab Med.
2007;
45
662-666
- 3
Boi F, Maurelli I, Pinna G. et al .
Calcitonin measurement in wash-out fluid from fine needle aspiration of neck masses
in patients with primary and metastatic medullary thyroid carcinoma.
Clin Endocrinol Metab.
2007;
92
2115-2118
- 4
Borson-Chazot F, Bardet S, Bournaud C. et al .
Guidelines for the management of differentiated thyroid carcinomas of vesicular origin.
Ann Endocrinol (Paris).
2008;
69
472-486
- 5
British Thyroid Association, Royal College of Physicians
.
Guidelines for the management of thyroid cancer .
, 2nd edition. Perros P, ed.
http://www.british-thyroid-association.org/news/docs/thyroid_cancer_guidelines_2007.pdf
- 6
Chow E, Siddique F, Gama R.
Thyrotoxicosis factitia: role of thyroglobulin.
Ann Clin Biochem.
2008;
45
447-448
- 7
Cooper DS, Doherty GM, Haugen BR. et al .
American Thyroid Association Guidelines Taskforce. Management guidelines for patients
with thyroid nodules and differentiated thyroid cancer.
Thyroid.
2006;
16
109-142
- 8
Costante G, Meringolo D, Durante C. et al .
Predictive value of serum calcitonin levels for preoperative diagnosis of medullary
thyroid carcinoma in a cohort of 5 817 consecutive patients with thyroid nodules.
J Clin Endocrinol Metab.
2007;
92
((2))
450-455
- 9
d’Herbomez M, Caron P, Bauters C. et al .
Reference range of serum calcitonin levels in humans: Influence of calcitonin assays,
sex, age, and cigarette smoking.
Eur J Endocrinol.
2007;
157
749-755
- 10
Dietlein M, Dressler J, Grünwald F. et al .
Deutsche Gesellschaft für Nuklearmedizin Guideline for in vivo- and in vitro procedures
for thyroid diseases (version 2).
Nuklearmedizin.
2003;
42
109-115
- 11
Dietlein M, Wieler H, Schmidt M. et al .
Calcitonin-Screening bei der Knotenstruma?.
Nuklearmedizin.
2008;
47
65-72
- 12
Dietlein M, Dressler J, Eschner W. et al .
Procedure guideline for iodine-131 whole-body scintigraphy for differentiated thyroid
cancer (version 3).
Nuklearmedizin.
2007;
46
206-212
- 13
Djemli A, Fillion M, Belgoudi J. et al .
Clin Twenty years later: a reevaluation of the contribution of plasma thyroglobulin
to the diagnosis of thyroid dysgenesis in infants with congenital hypothyroidism.
Biochem.
2004;
37
818-822
- 14
Dralle H, Schwarzrock R, Lang W. et al .
Comparison of histology and immunohistochemistry with thyroglobulin serum levels and
radioiodine uptake in recurrences and metastases of differentiated thyroid carcinomas.
Acta Endocrinol (Copenh).
1985;
108
504-510
- 15
Edmonds CJ, Willis CL.
Serum thyroglobulin in the investigation of patients presenting with metastases.
Br J Radiol.
1988;
61
317-319
- 16
Elisei R, Bottici V, Luchetti F. et al .
Impact of routine measurement of serum calcitonin on the diagnosis and outcome of
medullary thyroid cancer: Experience in 10 864 patients with nodular thyroid disorders.
J Clin Endocrinol Metab.
2004;
89
163-168
- 17
Engelbach M, Görges R, Forst T. et al .
Improved diagnostic methods in the follow-up of medullary thyroid carcinoma by highly
specific calcitonin measurements.
J Clin Endocrinol Metab.
2000;
85
1890-1894
- 18
Engelbach M, Heerdt S, Görges R. et al .
Is there an ectopic secretion of monomeric calcitonin in the human being?.
Langenbecks Arch Surg.
1998;
383
456-459
- 19
Eustatia-Rutten CF, Smit JW, Romijn JA. et al .
Diagnostic value of serum thyroglobulin measurements in the follow-up of differentiated
thyroid carcinoma, a structured meta-analysis.
Clin Endocrinol (Oxf).
2004;
61
61-74
- 20
Fatemi S, LoPresti JS.
A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk
patients with papillary thyroid carcinoma.
J Clin Endocrinol Metab.
2003;
88
4507-4508
- 21
Francis Z, Schlumberger M.
Serum thyroglobulin determination in thyroid cancer patients.
Best Pract Res Clin Endocrinol Metab.
2008;
22
1039-1046
- 22
Frasoldati A, Toschi E, Zini M. et al .
Role of thyroglobulin measurement in fine-needle aspiration biopsies of cervical lymph
nodes in patients with differentiated thyroid cancer.
Thyroid.
1999;
9
105-111
- 23
Gerfo PL, Colacchio T, Colacchio D. et al .
Thyroglobulin in benign and malignant thyroid disease.
JAMA.
1979;
241
923-924
- 24
Gimm O, Ukkat J, Dralle H.
Determinative factors of biochemical cure after primary and reoperative surgery for
sporadic medullary thyroid carcinoma.
World J Surg.
1998;
22
562-567
- 25
Giovanella L, Ceriani L, Ghelfo A. et al .
Thyroglobulin assay during thyroxine treatment in low-risk differentiated thyroid
cancer management: Comparison with recombinant human thyrotropin-stimulated assay
and imaging procedures.
Clin Chem Lab Med.
2006;
44
648-652
- 26
Giovanella L, Ceriani L, Suriano S. et al .
Thyroglobulin measurement on fine-needle washout fluids: Influence of sample collection
methods.
Diagn Cytopathol.
2009;
37
42-44
- 27
Giovanella L, Crippa-S, Cariani L.
Serum calcitonin-negative medullary thyreoid carcinoma: role of CgA and CEA as complementary
markers.
Int J Biol Markers.
2008;
23
129-131
- 28
Giovanella L.
Highly sensitive thyroglobulin measurements in differentiated thyroid carcinoma management.
Clin Chem Lab Med.
2008;
46
1067-1073
- 29
Girelli ME, Busnardo B, Amerio R. et al .
Critical evaluation of serum thyroglobulin (Tg) levels during thyroid hormone suppression
therapy versus Tg levels after hormone withdrawal and total body scan: Results in
291 patients with thyroid cancer.
Eur J Nucl Med.
1986;
11
333-335
- 30
Girelli ME, Busnardo B, Amerio R. et al .
Serum thyroglobulin levels in patients with well-differentiated thyroid cancer during
suppression therapy: Study on 429 patients.
Eur J Nucl Med.
1985;
10
252-254
- 31
Görges R, Bockisch A.
Der Schilddrüsenknoten und der Stellenwert der Tumormarkerbestimmung.
Der Nuklearmediziner.
2008;
31
228-236
- 32
Görges R, Brandt-Mainz K, Freudenberg L. et al .
Kontinuierliche Sensitivitatssteigerung in der Schilddrusenkarzinom-Nachsorge im Verlauf
dreier Thyreoglobulin-IMA-Generationen.
Nuklearmedizin.
2003;
43
157-166
- 33
Görges R, Jentzen W, Müller SP. et al .
Untersuchungen zur Dynamik des Thyreoglobulin-Anstieges beim progredienten differenzierten
Schilddrüsenkarzinom.
Nuklearmedizin.
2009;
48
A86
, (P21)
- 34
Görges R, Lind T, Schostok L. et al .
Serielle ultrasensitive Thyreoglobulin-Bestimmung: Differenzierung zwischen natürlichen
Schwankungen bei DTC-Patienten in Remission und Tumorrezidiven.
Nuklearmedizin.
2006;
45
A29
, (V66)
- 35
Görges R, Maniecki M, Jentzen W. et al .
Development and clinical impact of thyroglobulin antibodies in patients with differentiated
thyroid carcinoma during the first 3 years after thyroidectomy.
Eur J Endocrinol.
2005;
153
49-55
- 36
Hahm JR, Lee MS, Min YK. et al .
Routine measurement of serum calcitonin is useful for early detection of medullary
thyroid carcinoma in patients with nodular thyroid diseases.
Thyroid.
2001;
11
73-80
- 37
Hartung V, Broecker M, Bockisch A. et al .
Assay-Abhängigkeit der Calcitonin-Zielbereiche für „biochemical-cured” MTC-Patienten
in der Nachsorge.
Nuklearmedizin.
2010;
49
in print
- 38
Hartung V, Lahner H, Broecker M. et al .
Vergleich verschiedener Calcitonin-Assays in der Nachsorge bei Patienten mit medullärem
Schilddrüsenkarzinom.
Nuklearmedizin.
2010;
49
in print
- 39
Heinze H G, Rall M.
The value of a new IRMA for determining thyroglobulin.
Nuklearmedizin.
1992;
31
172-177
- 40
Henriksen JH, Schifter S, Moller S. et al .
Increased circulating calcitonin in cirrhosis Relation to severity of disease and
calcitonin gene-related peptide.
Metabolism.
2000;
49
47-52
- 41
Herrmann B L, Schmid K W, Görges R. et al .
Calcitonin screening and pentagastrin testing: predictive value for the diagnosis
of medullary carcinoma in nodular thyroid disease.
Eur J Endocrinol.
2010;
162
in print
- 42
Hocevar M, Auersperg M, Stanovnik L.
The dynamics of serum thyroglobulin elimination from the body after thyroid surgery.
Eur J Surg Oncol.
1997;
23
208-210
- 43
Hrafnkelsson J, Tulinius H, Kjeld M. et al .
Serum thyroglobulin as a risk factor for thyroid carcinoma.
Acta Oncol.
2000;
39
973-977
- 44
Jeon SJ, Kim E, Park JS. et al .
Diagnostic benefit of thyroglobulin measurement in fine-needle aspiration for diagnosing
metastatic cervical lymph nodes from papillary thyroid cancer: Correlations with US
features.
Korean J Radiol.
2009;
10
106-111
- 45
Karges W, Dralle H, Raue F. et al .
Calcitonin measurement to detect medullary thyroid carcinoma in nodular goiter: German
evidence-based consensus recommendation.
Exp Clin Endocrinol Diabetes.
2004;
112
52-58
- 46
Lando A, Holm K, Nysom K. et al .
Serum thyroglobulin as a marker of thyroid neoplasms after childhood cancer.
Acta Paediatr.
2003;
92
((11))
1284-1290
- 47
Lima N, Cavaliere H, Tomimori E. et al .
Prognostic value of serial serum thyroglobulin determinations after total thyroidectomy
for differentiated thyroid cancer.
J Endocrinol Invest.
2002;
25
110-115
- 48
Lind L, Bucht E, Ljunghall S.
Pronounced elevation in circulating calcitonin in critical care patients is related
to the severity of illness and survival.
Intensive Care Med.
1995;
21
63-66
- 49
Madeddu G, Casu AR, Costanza C. et al .
Serum thyroglobulin levels in the diagnosis and follow-up of subacute ‘painful’ thyroiditis.
A sequential study.
Arch Intern Med.
1985;
145
243-247
- 50
Mariotti S, Barbesino G, Caturegli P. et al .
Assay of thyroglobulin in serum with thyroglobulin autoantibodies: An unobtainable
goal?.
J Clin Endocrinol Metab.
1995;
80
468-472
- 51
Marrinan M, Skrabanek P, Moriarty M. et al .
Hypercalcitoninaemia in medullary carcinoma of the thyroid and other malignancies:
Value of calcitonin as tumour marker.
Horm Metab Res.
1982;
14
213-215
- 52
Martinetti A, Seregni E, Ferrari L. et al .
Evaluation of circulating calcitonin: analytical aspects.
Tumori.
2003;
89
566-568
- 53
Mazzaferri EL, Robbins RJ, Spencer CA. et al .
A consensus report of the role of serum thyroglobulin as a monitoring method for low-risk
patients with papillary thyroid carcinoma.
J Clin Endocrinol Metab.
2003;
88
1433-1441
- 54
Menzel C, Grünwald F, Biersack HJ.
Monitoring of low-risk patients with papillary thyroid carcinoma.
J Clin Endocrinol Metab.
2003;
88
4507
- 55
Morgenthaler NG, Froehlich J, Rendl J. et al .
Technical evaluation of a new immunoradiometric and a new immunoluminometric assay
for thyroglobulin.
Clin Chem.
2002;
48
1077-1083
- 56
Morita T, Tamai H, Ohshima A. et al .
Changes in serum thyroid hormone, thyrotropin and thyroglobulin concentrations during
thyroxine therapy in patients with solitary thyroid nodules.
J Clin Endocrinol Metab.
1989;
69
227-230
- 57
Moriyama K, Akamizu T, Umemoto M. et al .
A case of Hashimoto's thyroiditis with markedly elevated serum thyroglobulin and evidence
of its influence on the measurement of anti-thyroglobulin antibody by highly sensitive
assays.
Endocr J.
1999;
46
687-693
- 58
Morris LF, Waxman AD, Braunstein GD.
Interlaboratory comparison of thyroglobulin measurements for patients with recurrent
or metastatic differentiated thyroid cancer.
Clin Chem.
2002;
48
1371-1372
- 59
Müller-Gärtner HW, Schneider C, Tempel MT.
Serum-Thyreoglobulin in der Metastasendiagnostik des differenzierten Schilddrüsenkarzinoms.
Nuklearmedizin.
1986;
25
194-200
- 60
Müller-Gärtner HW, Schneider C.
Clinical evaluation of tumor characteristics predisposing serum thyroglobulin to be
undetectable in patients with differentiated thyroid cancer.
Cancer.
1988;
61
976-981
- 61
Niccoli P, Brunet P, Roubicek C. et al .
Abnormal calcitonin basal levels and pentagastrin response in patients with chronic
renal failure on maintenance hemodialysis.
Eur J Endocrinol.
1995;
132
75-81
- 62
Oishi S, Shimada T, Tajiri J. et al .
Elevated serum calcitonin levels in patients with thyroid disorders.
Acta Endocrinol (Copenh).
1984;
107
476-481
- 63
Pacini F, Fontanelli M, Fugazzola L. et al .
Routine measurement of serum calcitonin in nodular thyroid diseases allows the preoperative
diagnosis of unsuspected sporadic medullary thyroid carcinoma.
J Clin Endocrinol Metab.
1994;
78
826-829
- 64
Pacini F, Lari R, Mazzeo S. et al .
Diagnostic value of a single serum thyroglobulin determination on and off thyroid
suppressive therapy in the follow-up of patients with differentiated thyroid cancer.
Clin Endocrinol (Oxf).
1985;
23
405-411
- 65
Pacini F, Schlumberger M, Dralle H.
European Thyroid Cancer Taskforce
.
European consensus for the management of patients with differentiated thyroid carcinoma
of the follicular epithelium.
Eur J Endocrinol.
2006;
154
787-803
, [Erratum (2006) 155:385]
- 66
Panza N, Lombardi G, De Rosa M. et al .
High serum thyroglobulin levels Diagnostic indicators in patients with metastases
from unknown primary sites.
1987;
60
2233-2236
- 67
Pellegriti G, Scollo C, Regalbuto C. et al .
The diagnostic use of the rhTSH/thyroglobulin test in differentiated thyroid cancer
patients with persistent disease and low thyroglobulin levels.
Clin Endocrinol (Oxf).
2003;
58
556-561
- 68
Persoon AC, Jager PL, Sluiter WJ. et al .
A sensitive Tg assay or rhTSH stimulated Tg: what's the best in the long-term follow-up
of patients with differentiated thyroid carcinoma?.
PLoS One.
2007;
2
e816
- 69
Pötzi C, Moameni A, Karanikas G. et al .
Comparison of iodine uptake in tumour and nontumour tissue under thyroid hormone deprivation
and with recombinant human thyrotropin in thyroid cancer patients.
Clin Endocrinol (Oxf).
2006;
65
519-523
- 70
Preissner CM, O’Kane DJ, Singh RJ. et al .
Phantoms in the assay tube: heterophile antibody interferences in serum thyroglobulin
assays.
J Clin Endocrinol Metab.
2003;
88
3069-3074
- 71
Rieu M, Lame MC, Richard A. et al .
Prevalence of sporadic medullary thyroid carcinoma: the importance of routine measurement
of serum calcitonin in the diagnostic evaluation of thyroid nodules.
Clin Endocrinol (Oxf).
1995;
42
453-460
- 72
Rink T, Dembowski W, Schroth HJ. et al .
Impact of serum thyroglobulin concentration in the diagnosis of benign and malignant
thyroid diseases.
Nuklearmedizin.
2000;
39
133-138
- 73
Rink T, Truong PN, Schroth HJ. et al .
Calculation and validation of a plasma calcitonin limit for early detection of medullary
thyroid carcinoma in nodular thyroid disease.
Thyroid.
2009;
19
327-332
- 74
Saller B, Görges R, Reinhardt W. et al .
Sensitive calcitonin measurement by two-site immunometric assays: Implications for
calcitonin screening in nodular thyroid disease.
Clin Lab.
2002;
48
191-200
- 75
Sapin R, Gasser F, Chambron J.
Recovery determination in 600 sera analyzed for thyroglobulin with a recently commercialized
IRMA kit.
Clin Chem.
1992;
38
1920-1921
- 76
Schlumberger M, Berg G, Cohen O. et al .
Follow-up of low-risk patients with differentiated thyroid carcinoma: A European perspective.
Eur J Endocrinol.
2004;
150
105-112
- 77
Schlumberger M, Fragu P, Gardet P. et al .
A new immunoradiometric assay (IRMA) system for thyroglobulin measurement; in the
follow-up of thyroid cancer patients.
Eur J Nucl Med.
1991;
18
153-157
- 78 Schlumberger M, Pacini F. eds Thyroid tumors.
Serum thyroglobulin measurement, Chap 7.2.3 Éditions Nucléon, Paris 1999: 136-140
- 79
Schneider AB, Shore-Freedman E, Ryo UY. et al .
Prospective serum thyroglobulin measurements in assessing the risk of developing thyroid
nodules in patients exposed to childhood neck irradiation.
J Clin Endocrinol Metab.
1985;
61
((3))
547-550
- 80
Shah DH, Kumar A, Vijayan U. et al .
Clinical utility of serum thyroglobulin in metastatic disease.
Indian J Med Res.
1994;
100
232-236
- 81
Sheu SY, Görges R, Schmid KW.
Hyperplasien der Schilddrüse.
Pathologe.
2003;
24
348-356
- 82
Smallridge RC, Meek SE, Morgan MA. et al .
Monitoring thyroglobulin in a sensitive immunoassay has comparable sensitivity to
recombinant human tsh-stimulated thyroglobulin in follow-up of thyroid cancer patients.
J Clin Endocrinol Metab.
2007;
92
82-87
- 83
Snozek CL, Chambers EP, Reading CC. et al .
Serum thyroglobulin, high-resolution ultrasound, and lymph node thyroglobulin in diagnosis
of differentiated thyroid carcinoma nodal metastases.
J Clin Endocrinol Metab.
2007;
92
4278-4281
- 84
Spencer CA, LoPresti JS, Fatemi S. et al .
Detection of residual and recurrent differentiated thyroid carcinoma by serum thyroglobulin
measurement.
Thyroid.
1999;
9
435-441
- 85
Spencer CA, Takeuchi M, Kazarosyan M.
Current status and performance goals for serum thyroglobulin assays.
Clin Chem.
1996;
42
164-173
- 86
Spencer CA, Wang CC.
Thyroglobulin measurement.
Techniques, clinical benefits, and pitfalls. Endocrinol Metab Clin North Am.
1995;
24
841-863
- 87
Szanto J, Vincze B, Sinkovics I. et al .
Postoperative thyroglobulin level determination to follow up patients with highly
differentiated thyroid cancer.
Oncology.
1989;
46
99-104
- 88
Thoresen SO, Myking O, Glattre E. et al .
Serum thyroglobulin as a preclinical tumor marker in subgroups of thyroid cancer.
Br J Cancer.
1988;
57
105-108
- 89
Unger J.
Serum thyroglobulin concentration may be a clue to the mechanism of amiodarone-induced
thyrotoxicosis.
J Endocrinol Invest.
1988;
11
689
- 90
Uruno T, Miyauchi A, Shimizu K. et al .
Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens
for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer.
World J Surg.
2005;
29
483-485
- 91
Wang PW, Wang ST, Liu RT. et al .
Levothyroxine suppression of thyroglobulin in patients with differentiated thyroid
carcinoma.
J Clin Endocrinol Metab.
1999;
84
4549-4553
- 92
Weightman DR, Mallick UK, Fenwick JD. et al .
Discordant serum thyroglobulin results generated by two classes of assay in patients
with thyroid carcinoma: Correlation with clinical outcome after 3 years of follow-up.
Cancer.
2003;
98
41-47
- 93
Zöphel K, Wunderlich G, Kotzerke J.
A highly sensitive thyroglobulin assay has superior diagnostic sensitivity for recurrence
of differentiated thyroid cancer in patients undergoing TSH suppression.
J Nucl Med.
2006;
47
552-553
- 94
Zöphel K, Wunderlich G, Liepach U. et al .
Wiederfindungstest oder immunradiometrische Bestimmung der Autoantikörper gegen Thyreoglobulin
zur Interpretation der Thyreoglobulinbestimmung in der Nachsorge des differenzierten
Schilddrüsenkarzinoms.
Nuklearmedizin.
2001;
40
155-163
- 95
Zöphel K, Wunderlich G, Smith BR.
Serum thyroglobulin measurements with a high sensitivity enzyme-linked immunosorbent
assay: is there a clinical benefit in patients with differentiated thyroid carcinoma?.
Thyroid.
2003;
13
861-865
PD Dr. Rainer Görges
Klinik für Nuklearmedizin
Universitätsklinikum Essen
Hufelandstraße 55
45122 Essen
Telefon: + 49/201/723-2032
Fax: + 49-201/723-5964
eMail: rainer.goerges@uni-due.de
