分化型甲状腺癌术后抑制状态下血清甲状腺球蛋白水平检测的临床诊断价值  

Clinical Value of Serumnon-Stimulated Thyroglobulin(nS-TG) in Differentiated Thyroid Cancer(DTC) Patients in after Thyroidectomy

作　　者：王永斌[1] 邓智勇[1] 肖世闻 孟新尧 WANG Yong-bin;DENG Zhi-yong;XIAO Shi-wen;MENG Xin-yao(Department of Nuclear,Yunnan Tumor Hospital,Kunming 650118,China)

机构地区：[1]云南省肿瘤医院核医学科

出　　处：《现代检验医学杂志》2019年第5期133-134,138,共3页Journal of Modern Laboratory Medicine

摘　　要：目的探讨分化型甲状腺癌(DTC)全切术后抑制状态时血清甲状腺球蛋白(TG)的临床价值。方法回顾性分析云南省肿瘤医院2018年2~9月,75例接受甲状腺全切和131Ⅰ清甲后的分化型甲状腺癌患者,口服甲状腺素片进行抑制治疗。用罗氏电化学发光e601检测血清TG,TSH和TG-Ab,安图A2000plus检测FT4,联合甲状腺B超,CT检查。采用Mann-WhitneyU检验比较转移组与未转移组TG,TSH,TG-Ab和FT4结果;通过受试者工作特征曲线(ROC)分析血清TG在甲状腺癌术后,抑制治疗时复发转移的诊断性能。结果分化型甲状腺癌术后,抑制状态,显像发现转移25例(33.3%),血清TG49.02ng/ml(95%CI:3.85~94.18ng/ml);未转移50例(66.7%),血清TG0.84ng/ml(95%CI:0.04~1.96ng/ml),两组之间血清TG比较,差异有统计学意义(χ^2=30.14,df=1,P<0.01)。通过ROC曲线分析,血清TG的ROC曲线下面积为0.88(95%CI:0.81~0.97,P<0.01),最佳切点值为1ng/ml,此时诊断复发或转移的灵敏度为84.2%,特异度为88%。结论抑制状态时血清TG水平变化有助于判断甲状腺癌术后复发或转移,甲状腺全切后抑制状态时血清TG水平为1ng/ml可作为判断复发转移的最佳切点值,有较好的临床诊断价值。Objective To evaluate the clinical value of serum non-stimulate thyroglobulin(nS-TG)in differentiated thyroid cancer(DTC)after thyroidectomy.Methods 75 patients with differentiated thyroid cancer(DTC)who had been treated with thyroidectomy between February to September 2018 in Yunnan Tumor Hospital.All of the patients had used thyroxine tablets.Used Roche 601 to assay the serum TG,TSH and TG-Ab,and Auto A2000 plus to assay FT4,and connecting medical imaging inspect,and used ROC curve to analyse the diagnosis characteristics of serum TG.Results The patients were divided into two groups through image:25(33.3%)transformed patients TG 49.02 ng/ml(95%CI:3.85~94.18)were more than the non-transform(66.7%)DTC patients which were 0.84 ng/ml(95%CI:0.04~2.11)(χ^2=30.14,df=1,P<0.01).The ROC curve analysis showed the area underthe curve was 0.88(95%CI:0.81~0.97,P<0.01),there was difference in 1 ng/ml between transformed patients and the non-transform,which the sensitivity was 84.2%and the specificity was 88%.Conclusion The serum non-stimulate thyroglobulin(nS-TG)is useful to prognostic DTC after thyroidectomy,and the best cut off levels is 1 ng/ml between transformed patients and the non-transform.

关 键 词：分化型甲状腺癌 抑制状态 甲状腺球蛋白 抗甲状腺球蛋白抗体 临床价值 

分 类 号：R736.1[医药卫生—肿瘤] R730.43[医药卫生—临床医学]