甲状腺自身抗体与分化型甲状腺癌的关系  

Relationship between Differentiated Thyroid Cancer and Serum Thyroid Autoantibodies

作　　者：李娇[1] 李莉[1] 于茂恒[1] 

机构地区：[1]天津市海河医院普外科,天津300350

出　　处：《中国城乡企业卫生》2017年第5期13-15,共3页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的探讨术前甲状腺自身抗体[甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)]的水平与分化型甲状腺癌的关系。方法回顾性分析2006年1月-2016年12月在天津市海河医院首次行甲状腺结节手术的患者773例,术后病理学明确诊断为分化型甲状腺癌(DTC)315例和良性甲状腺结节458例,检测两组患者术前TGAb、TPOAb水平,进行统计学分析。结果 DTC患者TGAb阳性率显著高于良性甲状腺结节患者(21.3%vs14.2%;P<0.05)。DTC患者与良性结节患者TPOAb阳性率比较差异无统计学意义(12.7%vs9.6%;P>0.05)。315例DTC患者中,TGAb阳性患者男性多于女性(P<0.05),TGAb阳性患者侵犯包膜比例(49.3%vs35.1%;P<0.05)以及淋巴结转移比例(41.8%vs28.6%;P<0.05)均高于TGAb阴性组,差异有统计学意义。但在年龄(P>0.05)、肿瘤大小(P>0.05)、癌灶特点(P>0.05)及肿瘤分期III/IV(P>0.05)方面差异无统计学意义。而TPOAb阳性与DTC患者临床病理特征并无相关性。结论术前检测TGAb可能是预测分化型甲状腺癌风险的一个指标,与恶性肿瘤侵及包膜以及淋巴结转移有一定相关性。Objective To investigate the feasibility and clinical value of thyroid peroxidase antibody（TPOAb）and thyroglobulin antibody（TGAb）in predicting differentiated thyroid cancer（DTC）. Methods From January 2006 to December 2016,773 patients with thyroid nodule underwent their first thyroidectomy in Tianjin Haihe Hospital,315 cases were diagnosed with DTC,and the other 458 cases were diagnosed with benign nodule by postoperative pathology. The levels of TGAb and TPOAb in patients of both groups were tested. Results There was significant difference in TGAb positive rate between DTC group and benign group（21.3% vs 14.2%;P〈0.05）,there was no significant difference in TPOAb level between DTC group and benign group（12.7% vs 9.6%;P〈0.05）. These data suggeste d that male with high levels TGAb mi gh t have relation to DTC,the difference was statistically significant（P〈0.05）. Elevated TGAb had a higher prevalence of extrathyroidal invasion（49.3% vs 35.1%;P〈0.05）and lymph node metastasis（41.8% vs 28.6%;P〈0.05）. In addition,there was no statistical signifcance in age（P〉0.05）,the mean nodule size（P〉0.05）,nodule type（P〉0.05）and advanced stages（III,IV）（P〉0.05）between two groups. There was no significant relationship between clinical characteristics of DTC and TPOAb level. Conclusion This study reveals that patients with high TGAb concentrations may be predisposed to DTC. The elevated TGAb level is correlated to DTC with extrathyroidal invasion and lymph node metastasis.

关 键 词：甲状腺球蛋白抗体 甲状腺过氧化物酶抗体 分化型甲状腺癌 

分 类 号：R6[医药卫生—外科学]