摘要
目的 研究分析分化型甲状腺癌(differentiated thyroid carcinoma)合并桥本甲状腺炎患者手术及131碘治疗后,血清甲状腺球蛋白(thyroglobulin,Tg)与抗甲状腺球蛋白抗体(antithyroglobulin antibody,TgAb)水平对甲状腺癌转移的诊断价值,并确定其相应的危险度.方法 共154例分化型甲状腺癌合并桥本甲状腺炎患者,所有患者术后均接受131碘治疗,并进行3年随访.154例患者分为有或无复发/转移组,根据不同Tg水平分为3个亚组分别为:Tg≤1 μg/L组,1μg/L＜Tg≤10 μg/L组和10 μg/L＜Tg≤100 μg/L,以TgAb＞40 kIU/L被认为TgAb阳性,进行相对危险度分层分析,研究各不同Tg水平组别中,TgAb阳性对转移的预测价值.结果 当Tg≤1 μg/L时,TgAb＞40 kIU/L对复发或转移的诊断价值最大,转移相对危险度是27.000(95％ CI6.727 ～ 108.374),TgAb阳性与转移高度相关.而当Tg＞1 μg/L时,应以Tg水平为准.此外,TgAb的水平与甲状腺癌的病理类型关系不大.结论 在Tg≤1 μg/L患者中,TgAb＞40 kIU/L是预测甲状腺癌复发或转移的最佳值.
Objective To investigate the value of serum thyroglobulin (Tg) and antithyroglobulin antibody (TgAb) in differentiated thyroid carcinoma complicated with Hashimoto's thyroiditis after thyroid ablation.Methods Serum Tg and TgAb levels and the status of illness in 154 differentiated thyroid carcinoma patients with coexistent Hashimoto's thyroiditis and confirmed pathology after surgery followed by remnant ablation were performed during three years follow up.Tg and TgAb levels were assessed by chemiluminescent immunoassay assay.The cases were divided into three groups (according to the level of Tg):Tg ≤ 1 μg/L group,1 μg/L＜Tg ≤ 10 μg/L group and 10 μg/L＜Tg≤ 100 μg/L group.TgAb＞40 kIU/L was considered as positive,Cox's proportional hazard model was used to analyse prognostic value in different levels of Tg and TgAb for disease-free survival and recurrence.Results Compared with 1 μg/L＜Tg≤ 10 μg/L group and 10 μg/L＜Tg≤ 100 μg/L group,the relative risk in reflecting cancer recurrence (TgAb＞40 kIU/L) in Tg ≤ 1 μg/L group was 27.000 (95 ％ CI 6.727-108.374).The value of TgAb＞40 kIU/L in Tg≤ 1 μg/L group was greatly increased and highly correlated with metastasis.However,In the condition of Tg＞ 1 μg/L,the disease will be based on the level of TgAb.Conclusion The value of TgAb＞40 kIU/L in Tg ≤ 1 μg/L group seems to be the optimal cutoff value correlated with recurrence and metastasis of differentiated thyroid carcinoma.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2014年第4期-,共5页
Chinese Journal of Endocrinology and Metabolism
