血清Tg水平监测在孕妇及儿童中的应用
对于DTC孕妇，无论是妊娠期间首次发现还是已经诊断需要随访的患者，都需专科医生的详细指导。有关孕妇血清Tg水平的研究很少，由于妊娠阶段特殊性，可能导致检验结果的相互矛盾[30]。此外，严禁在孕妇中进行TSH刺激下（撤退L-T4或注射rhTSH）血清Tg水平的测定。建议对DTC孕妇进行血清Tg水平的监测，如升高提示需进行更仔细的颈部触诊及超声检查。
儿童甲状腺癌不常见，其发生率为1%～1.5%。儿童甲状腺结节为恶性的风险较成年人高。儿童血清Tg水平监测与对策和成年人相同。一项横断面研究发现7～18岁儿童血清Tg水平不存在性别差异，但与年龄呈负相关。有研究表明儿童和青少年血清Tg水平随年龄增长而下降，考虑可能与TSH水平的变化有关。
总之，Tg是甲状腺一种主要自身抗原，血清Tg水平测定对甲状腺疾病的诊断具有一定价值。不同甲状腺疾病患者血清Tg水平变化各有特点，即使同一疾病的不同阶段也可能存在差异。Tg是甲状腺腺体形态完整性的特殊标志物。Tg作为 DTC 标志物，当其阳性时具有较高的灵敏度，是评价 DTC全切或近全切及131I清甲治疗后复发与转移最敏感和特异的指标，对肿瘤复发与转移灶的早期发现具有重要临床价值。DTC患者术前测定血清Tg水平价值有限，应在全切或近全切及131I清甲治疗后6～12个月进行检测。对于血清Tg水平的解读应结合甲状腺切除范围及当前TSH水平。临床工作中应该重视内源性TgAb对Tg检测结果的影响，监测血清Tg和TgAb时，需在相同实验室采用同一种检测方法，避免因不同检测方法导致的误差。
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