摘要
目的 分析血清甲状腺球蛋白(Tg)、甲状腺球蛋白抗体(TgAb)及促甲状腺激素水平(TSH)监测在分化型甲状腺癌(DTC)131I治疗随访中的意义。方法 选取2017年1月至2022年7月于江苏大学附属医院肿瘤外科确诊的DTC患者121例为研究对象,根据随访结果,将75例未发生转移患者纳入未转移复发组,46例发生转移患者纳入转移复发组。对比术前、术后3个月、术后6个月患者血清Tg、TgAb及TSH水平,分析影响DTC患者术后转移的单因素,采用多元Logistic回归分析血清Tg、TgAb及TSH水平对DTC患者术后发生转移的相关因素以及不同筛查方法的阳性率。结果 治疗后3个月以及治疗后6个月,患者的血清Tg、TgAb、TSH水平均低于治疗前,差异有统计学意义(P<0.05);转移复发组和未转移复发组两组性别、年龄、手术次数、病灶位置、病理类型比较差异无统计学意义(P>0.05);两组手术方式、Tg、TgAb、TSH测量值比较差异有统计学意义(P<0.05);经Logistic回归分析显示:手术方式为近全切、血清Tg>0.84 ng/mL、TgAb>62 U/mL、TSH>5.5 IU/mL均是影响DTC患者治疗后发生复发转移的危险因素(P<0.05);Tg+TgAb+TSH、^(131)I-WBS阳性筛查率均低于Tg、TgAb、TSH的阳性筛查率,差异有统计学意义(P<0.05)。结论 血清Tg、TgAb及TSH可用于评价DTC患者治疗后的疗效以及有无转移或复发,Tg+TgAb+TSH筛查可避免DTC患者治疗后假阳性的误诊,具有较高的临床价值。
Objective To analyze the significance of serum thyroglobulin(Tg),thyroglobulin antibody(TgAb)and thyroid stimulating hormone(TSH)monitoring in follow-up of ^(131)I therapy in differentiated thyroid cancer(DTC).Methods 121 patients with DTC who were diagnosed in the tumor surgery department of our hospital from January 2017 to July 2022 were selected as the study objects.The serum Tg,TgAb and TSH levels in patients were compared before surgery,3 months after surgery,6 months after surgery,the single factor affecting postoperative metastasis of DTC patients was analyzed.Multiple Logistic regression analysis was used to analyze the related factors of serum Tg,TgAb and TSH levels on postoperative metastasis of DTC patients and different screening methods positive rate.Results 3 months after treatment and 6 months after treatment,the serum Tg,TgAb,and TSH levels of the patients were lower than those before treatment(P<0.05).There were no statistically significant differences in gender,age,number of operations,lesion location,and pathological type between the two groups(P>0.05).The differences in surgical methods,Tg,TgAb,and TSH measurements between the two groups were statistically significant(P<0.05).Logistic regression analysis showed that:the surgical methods were total gold resection,serum Tg>0.84 ng/mL,TgAb>62 U/mL,TSH>5.5 IU/mL were all independent risk factors affecting postoperative metastasis in DTC patients;the positive screening rates of Tg+TgAb+TSH and ^(131)I-WBS were lower than those of Tg,TgAb and TSH,the difference was statistically significant(P<0.05).Conclusion Serum Tg,TgAb and TSH can be used to evaluate the efficacy of DTC patients after treatment and whether there is metastasis or recurrence.Tg+TgAb+TSH screening can avoid false positive misdiagnosis of DTC patients after treatment,which has high clinical value.
作者
潘林宏
李林
黄鹏
PAN Linhong;LI Lin;HUANG Peng(Department of Nuclear Medicine,Affiliated Hospital of Jiangsu University,Zhenjiang,Jiangsu,China,233003)
出处
《分子诊断与治疗杂志》
2023年第10期1816-1819,共4页
Journal of Molecular Diagnostics and Therapy
基金
江苏省自然科学基金资助项目(BK201912235)。
