血清促甲状腺激素、甲状腺过氧化物酶抗体和甲状腺球蛋白抗体在甲状腺乳头状癌中的表达及其临床意义  

Expressions of serum thyroid stimulating hormone, thyroid peroxidase antibody and thyroglobulin antibody in papillary thyroid carcinoma and their clinical significances

作　　者：张艳[1] 龙厚隆[1] 杨汶士[1] 王洪凌[1] Zhang Yan;Long Houlong;Yang Wenshi;Wang Hongling(Department of Breast and Thyroid Surgery,the Central People's Hospital of Tengzhou,Tengzhou 277500,China)

机构地区：[1]滕州市中心人民医院乳腺甲状腺外科,滕州277500

出　　处：《肿瘤研究与临床》2023年第2期120-123,共4页Cancer Research and Clinic

摘　　要：目的探讨血清促甲状腺激素(TSH)、甲状腺过氧化物酶抗体(TPO-Ab)、甲状腺球蛋白抗体(Tg-Ab)水平与甲状腺乳头状癌发生、发展的关系。方法回顾性分析滕州市中心人民医院2021年1月至12月接受手术治疗的574例甲状腺结节患者的临床资料。以组织病理学诊断为金标准,将患者分为甲状腺乳头状癌组(恶性组,267例)及甲状腺良性结节组(良性组,307例),比较两组患者的一般资料及术前血清TSH、TPO-Ab、Tg-Ab水平。采用logistic回归分析术前血清TSH、TPO-Ab、Tg-Ab水平与甲状腺乳头状癌的相关性。结果恶性组与良性组患者年龄、性别比较,差异均无统计学意义(均P>0.05)。恶性组TSH[2.37 mIU/L(1.43 mIU/L,5.09 mIU/L)]、TPO-Ab[17.84 IU/ml(11.94 IU/ml,40.68 IU/ml)]、Tg-Ab[15.69 IU/ml(10.57 IU/ml,132.00 IU/ml)]均高于良性组[TSH 1.60 mIU/L(0.88 mIU/L,2.57 mIU/L),TPO-Ab 14.29 IU/ml(10.00 IU/ml,21.17 IU/ml),Tg-Ab 12.23 IU/ml(10.00 IU/ml,16.51 IU/ml)],差异均有统计学意义(Z值分别为-6.43、-4.60、-6.15,均P<0.05)。多因素logistic回归分析显示,TPO-Ab阳性(OR=0.996,95%CI 0.993~0.999,P=0.013)、Tg-Ab阳性(OR=0.996,95%CI 0.994~0.998,P<0.05)是甲状腺乳头状癌的独立危险因素。结论术前血清TSH、TPO-Ab、Tg-Ab水平与甲状腺乳头状癌关系密切,其中血清TPO-Ab阳性、Tg-Ab阳性是甲状腺乳头状癌的独立危险因素,在甲状腺结节良恶性鉴别诊断中具有重要价值。Objective To explore the relationship between serum levels of thyroid stimulating hormone(TSH),thyroid peroxidase antibody(TPO-Ab)and thyroglobulin antibody(Tg-Ab)and the development of papillary thyroid carcinoma.Methods The clinical data of 574 patients with thyroid nodules who received surgical treatment in Tengzhou Central People's Hospital from January to December 2021 were retrospectively analyzed.Using histopathological diagnosis as the gold standard,the patients were divided into papillary thyroid carcinoma group(malignant group,267 cases)and benign thyroid nodules group(benign group,307 cases).The clinical data and the preoperative serum TSH,TPO-Ab and Tg-Ab levels were compared between the two groups.The correlation between preoperative serum TSH,TPO-Ab and Tg-Ab levels and papillary thyroid cancer was analyzed by logistic regression.Results There were no statistical differences in the age and gender of patients between the malignant group and the benign group(all P>0.05).TSH[2.37 mIU/L(1.43 mIU/L,5.09 mIU/L)],TPO-Ab[17.84 IU/ml(11.94 IU/ml,40.68 IU/ml)]and Tg-Ab[15.69 IU/ml(10.57 IU/ml,132.00 IU/ml)]in the malignant group were higher than those in the benign group[TSH 1.60 mIU/L(0.88 mIU/L,2.57mIU/L),TPO-Ab 14.29 IU/ml(10.00 IU/ml,21.17 IU/ml),Tg-Ab 12.23 IU/ml(10.00 IU/ml,16.51 IU/ml)],and the differences were statistically significant(Z values were-6.43,-4.60 and-6.15,all P<0.05).Multivariate logistic regression analysis showed that positive TPO-Ab(OR=0.996,95%CI 0.993-0.999,P=0.013)and positive Tg-Ab(OR=0.996,95%CI 0.994-0.998,P<0.05)were independent risk factors for papillary thyroid cancer.Conclusions Preoperative serum TSH,TPO-Ab and Tg-Ab levels are closely related to papillary thyroid cancer,among which positive serum TPO-Ab and positive Tg-Ab are independent risk factors for papillary thyroid cancer and have important values in the differential diagnosis of benign and malignant thyroid nodules.

关 键 词：乳头状甲状腺癌 促甲状腺激素 甲状腺过氧化物酶抗体 甲状腺球蛋白抗体 

分 类 号：R736.1[医药卫生—肿瘤]