基线刺激甲状腺球蛋白水平在预测甲状腺乳头状癌^(131)I“清甲”疗效的价值  

Baseline Stimulated Thyroglobulin Level in Predicting Ablation Outcome for Patients with Papillary Thyroid Cancer Undergoing Radioiodine Remnant Ablation

作　　者：龙斌[1] 张丽军[1] 叶挺[1] 叶雪梅[1] 易贺庆[1] 李林法[1] 

机构地区：[1]浙江省肿瘤医院,浙江杭州310022

出　　处：《肿瘤学杂志》2016年第6期473-477,共5页Journal of Chinese Oncology

基　　金：浙江省医药卫生科技计划一般项目(2015KYB058)

摘　　要：[目的]探讨甲状腺乳头状癌术后TSH刺激状态下甲状腺球蛋白(STg)水平预测^(131)I清甲疗效的价值。[方法]回顾性分析首次^(131)I清甲治疗的138例甲状腺乳头状癌患者资料,其中男性35例,女性103例,中位年龄(45.69±11.93)岁,分析基线STg水平对清甲成功(清甲后6~12个月STg<1ng/ml、DxWBS未见甲状腺床摄碘、颈部超声未见甲状腺残留)的预测价值。[结果 ]总清甲成功率为73.9%(102/138),清甲成功组与失败组基线STg值分别为(7.82±10.57)ng/ml、(57.97±97.56)ng/ml,两者具有统计学差异(t=-5.14,P<0.001),采用ROC曲线分析STg截断值为12.8ng/ml,当STg≤12.8ng/ml时,其预测清甲成功的灵敏度、特异性、阳性预测值、阴性预测值分别为63.89%、83.33%、91.56%、44.90%,结果显示86.6%(84/97)STg≤12.8ng/ml患者和43.9%(18/41)STg>12.8ng/ml患者清甲成功。[结论]甲状腺乳头状癌术后^(131)I治疗前TSH刺激下Tg水平是一个可靠的预测清甲疗效的指标。[Objective] To investigate the predicting value of baseline stimulated thyroglobulin（STg） level for ablation outcome in patients with papillary thyroid cancer（PTC） undergoing radioiodine remnant ablation（RRA）. [Methods] Clinical data of 138 PTC patients including 35 males and 103 females with mean age of 45.69 ±11.93 years,who underwent total thyroidectomy followed by RRA,were retrospectively analyzed. The successful ablation was defined as STg1ng/ml,negative finding in whole body iodine scan（DxWBS） and neck ultrasonography at 6~12 months after RRA. The predictive value of baseline STg level for successful RRA was analyzed. [Results] The overall successful ablation rate was73.9%（102/138）. The mean baseline STg levels in successful ablation group and failure group were（7.82±10.57）ng/ml and（57.97±97.56）ng/ml,respectively（t=-5.14,P0.001）. Using baseline STg≤12.8ng/ml as cut-off value for predicting successful ablation,the sensitivity,specificity,positive predictive value and negative predictive value were 63.89%,83.33%,91.56% and 44.90%,respectively. Successful ablation was found in 86.6%（84/97） of patients with baseline STg≤12.8ng/ml and 43.9%（18/41） patients with baseline STg12.8ng/ml. [Conclusion] The baseline STg level may be used for prediction of successful ablation in PTC patients with total thyroidectomy followed by RRA.

关 键 词：甲状腺肿瘤 放射性碘治疗 甲状腺球蛋白 

分 类 号：R736.1[医药卫生—肿瘤]