分化型甲状腺癌术后131I治疗患者血清TPOAb、TGAb水平变化及其与疗效的关系  

Changes in serum levels of TPOAb and TGAb in patients with differentiated thyroid carcinoma after operative 131I treatment and their relationship with curative effect

作　　者：樊仁红[1] 张春华[1] 殷宇[1] FAN Ren-hong;ZHANG Chun-hua;YIN Yu(Department of Endocrinology,Jiangsu Institute of Nuclear Medicine Affiliated Jiangyuan Hospital,Wuxi Jiangsu 214063,China.)

机构地区：[1]江苏省原子医学研究所附属江原医院内分泌科

出　　处：《临床和实验医学杂志》2019年第18期1967-1970,共4页Journal of Clinical and Experimental Medicine

基　　金：江苏省临床医学科技专项(编号:BL20160022)

摘　　要：目的探讨分化型甲状腺癌术后131I治疗患者血清抗甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TG-Ab)水平变化及其与疗效的关系。方法回顾性选取2015年1月至2018年1月江苏省原子医学研究所附属江原医院收治的分化型甲状腺癌术后131I治疗患者150例作为癌症组,同期选取体检中心健康人员115例作为健康组,检测所有人员血清TPOAb、TGAb水平。比较两组血清TPOAb、TGAb水平,观察癌症组的临床疗效,比较有效者和无效者血清TPOAb、TGAb水平,绘制不同方法评估131I疗效的受试者工作曲线(ROC曲线)分析,分析不同方法评估131I疗效的效能。结果癌症组患者血清TPOAb、TGAb水平明显高于健康组,差异具有统计学意义(P <0. 05);癌症组131I治疗后,完全缓解5例(3. 33%)、部分缓解58例(38. 67%)、稳定60例(40. 00%)、进展27例(18. 00%),有效率为42. 00%;治疗有效者治疗后血清TPOAb、TGAb水平明显低于治疗前和治疗无效者治疗后,治疗有效者血清TPOAb、TGAb水平下降百分比明显高于治疗无效者,差异有统计学意义(P <0. 05),治疗无效者治疗后血清TPOAb、TGAb水平低于治疗前,但差异无统计学意义(P> 0. 05);ROC曲线分析结果显示,在评估131I疗效有效性的敏感度、特异度、准确度中,TPOAb下降百分比以> 30%为临界值时为82. 54%、82. 76%、82. 67%,TGAb下降百分比以> 35%为临界值时为85. 71%、86. 21%、86. 00%,两者联合时为96. 83%、97. 70%、97. 33%,TPOAb联合TGAb时诊断效能明显高于两者单独时,差异具有统计学意义(P <0. 05)。结论131I治疗分化型甲状腺癌术后患者后,血清TPOAb、TGAb水平下降,两者水平变化可作为评估131I疗效的重要指标,且两者联合时具有更佳的评估效能。Objective To explore the changes in serum levels of thyroid peroxidase antibody (TPOAb) and thyroglobulin antibody (TGAb) in postoperative 131 I treated patients with differentiated thyroid carcinoma and their relationship with curative effect. Methods 150 postoperative 131 I treated patients with differentiated thyroid carcinoma were retrospectively selected in cancer group during January 2015 to January 2018 in this hospital, and 115 healthy persons at the same time were selected as control group, and serum levels of TPOAb and TGAb in all these persons were detected. The serum levels of TPOAb and TGAb were compared between these two groups, and the clinical efficacy of cancer group was observed, the serum levels of TPOAb and TGAb were compared between effective and ineffective patients, and the ROC curve for evaluating the efficacy of 131 I by different methods was drawn, and the effectiveness of different methods in evaluation of the efficacy of 131 I was analyzed. Results The serum levels of TPOAb and TGAb in cancer group were significantly higher than those of control group, and the difference was statistically significant ( P <0.05). After 131 I treatment, in cancer group, 5 cases (3.33%) got complete remission, 58 cases (38.67%) got partial remission, 60 cases with stable status of disease, 27 cases (18.00%) got progression, and their effective rate was 42.00%. After treatment, serum levels of TPOAb and TGAb in patients with effective treatment were significantly lower than those before treatment and ineffective treatment patients. The serum levels of TPOAb and TGAb were decreased, and the percentage of effective treatment patients was significantly higher than that of ineffective treatment patients, and the difference was statistically significant ( P <0.05). The serum levels of TPOAb and TGAb in ineffective patients after treatment were lower than those before treatment, but the difference was not statistically significant ( P >0.05). The result of ROC curve analysis showed that in assessing the sensitiv

关 键 词：分化型甲状腺癌 术后131I治疗 抗甲状腺过氧化物酶抗体 甲状腺球蛋白抗体 疗效 

分 类 号：R736.1[医药卫生—肿瘤]