摘要
目的分析促甲状腺激素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)在桥本甲状腺炎(HT)和甲状腺乳头状癌(PTC)中的鉴别诊断价值。方法选取2015年2月—2017年3月新疆医科大学第一附属医院血管甲状腺外科收治甲状腺疾病患者244例,按疾病类别分组,其中甲状腺良性肿瘤组153例,PTC组65例,HT组26例,检测并比较各组患者甲状腺功能及TPOAb水平,分析比较各组TSH异常和TPOAb阳性情况,评价TSH及TPOAb鉴别诊断HT、PTC的价值。结果 3组患者甲状腺功能T_3、T_4、FT_3和FT4_水平比较差异无统计学意义(F=2.034、1.847、1.066、0.896,P=0.278、0.324、0.403、0.784);HT组TSH及TPOAb水平最高,其次为PTC组、甲状腺良性肿瘤组,3组比较差异有统计学意义(F=8.211、17.541,P=0.046、0.018)。3组TSH异常率和TPOAb阳性率比较,HT组最高(61.54%和50.00%),其次为PTC组(41.54%、26.15%)、甲状腺良性肿瘤组(22.22%、9.15%),3组比较差异有统计学意义(F=19.982、29.047,P=0.015、0.007)。TSH及TPOAb鉴别诊断HT和PTC最佳cut-off值分别为4.25m IU/L和75.50 IU/ml,此时敏感度分别为80.20%和74.51%,特异度分别为70.40%和68.50%,约登指数分别为0.506和0.430。结论 TSH、TPOAb在鉴别诊断桥本甲状腺炎和甲状腺乳头状癌中有一定的作用,值得进一步研究。
Objective To investigate the diagnostic value of thyroid stimulating hormone(TSH)and anti-thyroid peroxidase antibody(TPOAb)in Hashimoto's thyroiditis(HT)and papillary thyroid carcinoma(PTC).Methods Two hundred and forty-four patients came to First Affiliated Hospital of Xinjiang Medical University for treatment of thyroid diseases from February 2015 to March 2017 were grouped according to the categories of diseases;and thyroid benign tumor group were 153 cases,PTC group were 65 cases,HT group were 26 cases.Thyroid function and TPOAb levels of each group were detected and compared,TSH abnormalities and TPOAb positive cases were analyzed and compared,and the value of TSH and TPOAb in differential diagnosis of HT was evaluated.Results The detection levels of T 3,T 4,FT 3 and FT 4 in thyroid function were not significantly different among the three groups(F=2.034,F=1.847,F=1.066,F=0.896,P=0.278,P=0.324,P=0.403,P=0.784).Compared with the level of TSH and TPOAb,the HT group was(4.90±0.95)mIU/L and 84.52(24.64,1708.50)IU/ml,which was the highest,and followed by the PTC group and the thyroid benign tumor group,there was obvious difference among the groups(F=8.211,F=17.541,P=0.046,P=0.018).Compared with TSH abnormal rate and TPOAb positive rate of the three groups,the HT group was 61.54%and 50%,which was the highest,and followed by the PTC group and the thyroid benign tumor group,there was obvious difference among the groups(F=19.982,F=29.047,P=0.015,P=0.007).TSH and TPOAb differential diagnosis of HT and PTC cut-off values were 4.25 mIU/L and 75.50 IU/ml,the sensitivity were 80.20%and 74.51%,specificity were 70.40%and 68.50%,Youden index were 0.506 and 0.430 respectively.Conclusion TSH and TPOAb play an important role in differential diagnosis of Hashimoto's thyroiditis and papillary thyroid carcinoma,which is worthy of further study.
作者
吾甫尔.依马尔
王护国
哈力木拉提
李新喜
WUFUER·Yimaer;WANG Huguo;Halimulati;LI Xinxi(Department of Thyroid Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《疑难病杂志》
CAS
2018年第4期387-390,共4页
Chinese Journal of Difficult and Complicated Cases
基金
新疆重大疾病医学重点实验室开放课题(SKLIB-XJMDR-2016-6)
关键词
促甲状腺激素
过氧化物酶抗体
桥本甲状腺炎
甲状腺乳头状癌
鉴别诊断
Thyroid stimulating hormone
Peroxidase antibody
Hashimoto's thyroiditis
Papillary thyroid carcinoma
Differential diagnosis
