Klinisyenler İçin Tiroglobulin Ölçüm Yöntemleri

Yıl 2021, Cilt: 13 Sayı: 2, 64 - 82, 19.10.2021

Uğur Alp Göksu

Öz

Son yıllarda differansiye tiroid kanseri görülme sıklığı belirgin şekilde artmaktadır. Tiroglobulin sadece tiroid follikül hücresinde sentezlenmesi ve dolaşıma verilmesi DTK’li hastaların takibinde tümör belirteci olarak kullanılmasını sağlamıştır. Günümüzde standart takip, Tg ölçümü ve boyun ultrasonografisini içermektedir. Uygun endikasyonda tüm vücut iyot taraması yapılabilir. Klinik rehberlerde küçük odakların saptanmasında suboptimal sensitiviteye sahip Tg ölçümlerin kullanılması durumunda ekzojen veya endojen TSH uyarımı sonrası Tg ölçümü önerilmektedir. Bununla birlikte günümüzde yüksek sensitivite oranlarına sahip metotların kullanılmasıyla, TSH uyarımına gerek olmadan çok düşük konsantrasyonlardaki Tg’nin doğru saptanmasını, bazı dezavantajlarına rağmen, sağlamaktadır. Tg’nin hangi yöntemle bakıldığı, anti tg ve heterofil antikor varlığında olabilecek değişikliği bilerek kullanılması klinisyen için önemlidir. Klinisyenler tarafından bu yeni metotların avantaj ve dezavantajının bilinmesi, hem serum hem de Tg–yıkama sonuçlarının doğru değerlendirilerek, hastaya gereksiz tetkik yapılmasını önleyecektir.

Anahtar Kelimeler

Tiroglobulin, Tiroglobulin ölçüm yöntemleri, İnterferans

Thyroglobulin Measurement Methods for Clinicians

Öz

The frequency of differentiated thyroid cancer has increased markedly in recent years. Thyroglobulin is synthesized only in the thyroid follicle cell and given to the circulation, it has been used as a tumor marker in the follow-up of patients with DTC. Currently standart follow up DTC comprises Tg measurement and neck ultrasound. In adequate indication whole body radioiodine scan make up. Clinical guidelines recommended that, measurement of Tg after stimulation by endogenous or exgogenous TSH to detect occult disease focus when suboptimal sensitivity of Tg assays used. However, nowadays, highly sensitivity methods used with despite of disadvantage, without the need TSH stimulation, at very low Tg concentrations ensured correct detection. In which methods used for Tg assays and possible change in the presence of thyroglobuline and heterophile antibody very important for clinicians. This new methods to be know the advantages and disadvantages by clinicians, the results of serum and Tg washout evaluated corretly, prevented the patient’s unnecessary investigation.

Anahtar Kelimeler

Thyroglobulin, Thyroglobulin Measurement methods, İnterferance

Kaynakça

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