组织多肽抗原在甲状腺癌诊治中的应用价值  

Application Value of Tissue Polypeptide Antigen in Thyroid Carcinoma

作　　者：喻晶[1] 王堃[1] 雷旦生[1] 

机构地区：[1]湖北省肿瘤医院检验科,湖北武汉430079

出　　处：《武汉大学学报（医学版）》2015年第5期736-738,共3页Medical Journal of Wuhan University

摘　　要：目的:评估组织多肽抗原(TPA)在甲状腺癌诊断与疗效监测中的应用价值。方法:用化学发光法检测138例甲状腺癌患者、25例甲状腺良性疾病患者及65名健康对照者血清TPA水平,同时测定甲状腺癌标志物(TG、CEA),对结果进行比较分析。结果:在甲状腺癌组中,血清TPA水平(中位数为108.8U/L)明显高于甲状腺良性疾病患者(中位数为44.46U/L)和健康对照(中位数为55.63U/L)(均P<0.01)。根据受试者操作特性曲线(ROC曲线)分析,TPA检测甲状腺癌的临界值为78U/L,敏感度为63.04%,特异度为88.9%。相比于其他甲状腺癌标志物(CEA、TG),灵敏度较高,特异度稍低。此外,甲状腺患者血清TPA水平及阳性率随着肿瘤分期的升高而升高,淋巴结转移患者TPA水平显著高于未转移者(均P<0.05)。TPA水平与疗效也密切相关,临床治疗有效时TPA下降,而病情恶化或出现转移时则升高。结论:TPA测定有助于甲状腺癌的诊断和疗效监测。Objective： To evaluate serum tissue polypeptide antigen（TPA） as a biomarker for thyroid carcinoma. Methods： TPA was determined by CLIA in patients （n= 138） with thyroid carcino- ma, benign thyroid diseases group（n=25） and healthy controls（n=65）. Thyroid carcinoma bio- markers （TG and CEA） were also determined by CLIA. Results： The level of TPA was significantly higher in thyroid carcinoma group（median [108.8 U/L]） than that in benign thyroid disease group（median[44.46 U/L]） and healthy control group （median 55. 63 U/L, P=0. 000, 0. 000 respectively）. The receiver operation characteristic （ROC） analysis showed the cut-off val- ue to discriminate cancer from control was established at 78 U/L for TPA （sensitivity 63.04%, specificity 88.9%）. With the progression of thyroid carcinoma, the level of TPA as well as the sensitivity had an increase. TPA concentrations were higher in patients with lymph node metastasis than those without metastasis （P〈0.05）. Changes of TPA concentrations were correlated with tumor response. Elevated levels of TPA were found in recurrent disease patients, and the levels were decreased while the patients were sensitive to therapy. Conclusion： TPA determination is helpful in the diagnosis and prognosis of thyroid carcinoma.

关 键 词：组织多肽抗原 肿瘤标记 生物学 甲状腺癌 

分 类 号：R446.6[医药卫生—诊断学]