| 摘要: |
| 目的探讨血清甲状腺球蛋白（TG）水平对甲状腺未全部切除（未全切）的分化型甲状腺癌（DTC）患者术后是否发生肿瘤残留或复发/转移的诊断价值。方法将甲状腺未全切术后发生肿瘤残留或复发/转移的93例DTC患者作为研究组（A组），未发生肿瘤残留或复发/转移的118例DTC患者作为对照组（B组）；甲状腺球蛋白抗体（TGAB）阴性的65例A组患者设为C组，79例B组患者设为D组；TG阴性的46例A组患者设为E组，112例B组患者设为F组。分别比较A、B组间和A组二次手术前后以及C、D组间的TG水平差异，并分别比较A、B组间和A组二次手术前后以及E、F组间的TGAB水平差异；通过ROC曲线分别进行TG和TGAB的诊断价值评估。A、C、E各组均为二次手术前的水平，B、D、F各组均为术后随访水平。结果A组、A组术前、C组的TG水平分别高于B组、A组术后、D组的TG水平（均P＜0.05）。A、B组间和A组二次手术前后以及E、F组间的TGAB水平比较均无统计学差异（均P＞0.05）。TG水平监测对未全切DTC发生术后肿瘤残留或复发/转移有诊断价值（AUC=0.758，P＜0.05），灵敏度为0.505，特异度为0.949，提示无病生存的临界值为7.94IU/ml；而TGAB则无诊断价值。结论血清TG水平监测对于甲状腺未全切的DTC患者术后发生肿瘤残留或复发/转移具有一定的诊断价值，在随访中TG水平监测应列为常规检查项目。 |
| 关键词: 分化型甲状腺癌 甲状腺球蛋白 甲状腺球蛋白抗体 |
| DOI：10.12056/j.issn.1006-2785.2018.40.14.2018-22 |
| 分类号: |
| 基金项目:玉环县科技计划项目（201429） |
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| Diagnostic value of serum thyroglobulin for postoperative tumor residual or recurrence/metastasis in patients with differentiated thyroid cancer undergoing less than total thyroidectomy |
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| Abstract: |
| Objective To examine the diagnostic value of serum thyroglobulin (TG) level for postoperative tumor residual or recurrence/metastasis in patients with differentiated thyroid cancer (DTC) undergoing less than total thyroidectomy. Methods Among 211 DTC patients who had undergone less than total thyroidectomy, the postoperative tumor residual or recurrence/metastasis occurred in 93 cases (group A) and did not occur in 118 cases (group B). The patients were further divided into subgroups according to serum thyroglobulin antibody (TGAB）and thyroglobulin (TG) levels: TGAB was negative in 65 cases
of group A (group C) and in 79 cases of group B (group D); TG was negative in 46 cases of group A（group E）and in 112 cases of group B (group F). The diagnostic values of TG and TGAB for postoperative tumor residual and recurrence/metastasis were evaluated by ROC curve. Results The level of TG in group A was higher than that in group B; in group A the pre-operative level was higher than post-operative level and TG level in group C was higher than that in group D（all P＜0.05）. There was no
significant difference in the levels of TGAB between group A and group B, before and after operative in group A, between group E and group F ( all P ＞ 0 . 05 ) . The area of ROC curve ( AUC ) of TG for diagnosis of postoperative tumor residual and recurrence/metastasis was 0.758 (P＜0.05); taking 7.94 IU/ml as cutoff value of TG the sensitivity and specificity were 0.505 and 0.949, respectively. The AUC of TGAB was 0.479 (P ＞0.05) suggesting no clinical significance. Conclusion The serum TG is of diagnostic value for postoperative tumor residual or recurrence/metastasis in DTC patients who had undergone less than total thyroidectomy. |
| Key words: Differentiated thyroid cancer Thyroglobulin Thyroglobulin antibody |
