刺激性甲状腺球蛋白水平与中高危分化型甲状腺癌患者131碘治疗后临床转归的关系  

Relationship between the level of stimulating thyroglobulin and the clinical outcome after I treatment in patients with moderate to high-risk differentiated thyroid cancer

作　　者：林晓华[1] 高宙[1] 陈海波 李小强 庄伟清[3] LIN Xiao-hua;GAO Zhou;CHEN Hai-bo;LI Xiao-qiang;ZHUANG Wei-qing(Nuclear Medicine,Shenzhen Hospital,Peking University,Shenzhen 518000,China;Department of Thoracic Surgery,Shenzhen Hospital,Peking University,Shenzhen 518000,China;Outpatient Office,Shenzhen Hospital,Peking University,Shenzhen 518000,China)

机构地区：[1]北京大学深圳医院核医学科,广东深圳518000 [2]北京大学深圳医院胸外科,广东深圳518000 [3]北京大学深圳医院门诊办公室,广东深圳518000

出　　处：《中国现代普通外科进展》2020年第11期870-872,876,共4页Chinese Journal of Current Advances in General Surgery

摘　　要：目的:探究刺激性甲状腺球蛋白(ps-TG)水平与中高危分化型甲状腺癌(DTC)患者131碘治疗临床转归的关系。方法:回顾性分析行甲状腺全切手术456例DTC患者临床资料,随访中高危患者临床转归。根据治疗反应评估体系将其分为反应满意组(ER)、可接受(AR)组和欠佳(IR)组。分析各组患者的临床特征及131碘治疗前ps-TG水平,评价ps-TG水平对131碘治疗反应的临床预测价值。结果:ER、AR及IR三组患者性别、甲状腺外侵犯、颈部淋巴结转移及治疗前ps-TG水平存在统计学差异(P<0.001);IR组的131碘治疗前ps-Tg水平明显高于非IR组(P<0.001),ER组与AR组问差异无统计学意义(P=0.326)。诊断IR的ps-Tg界值点为28.3 ng/m L (敏感度57.5%,特异度87.1%),ROC曲线下面积(AUC=0.774,95%CI:0.701~0.847)。结论:ps-TG水平对中高危DTC患者131碘治疗后临床转归具有一定预测价值。Objective: To explore the relationship between the level of stimulating thyroglobulin before131 I treatment and the clinical outcome of patients with differentiated thyroid cancer at medium and high risk after131 I treatment. Methods: The clinical data of 456 patients with differentiated thyroid cancer who underwent total thyroidectomy from January,2015 to June,2018 were retrospectively analyzed.Follow-up observation was made on the clinical transformation of patients with moderate to high risk after operation, the excellent respons group(ER), the acceptable respnse group(AR)and the incomplete response group(IR)according to therapeutic response assessment system. The clinical characteristics of each group and thyroid globulin level before treatment with131 I were analyzed,the clinical value of predicting the optimal treatment response after treatment with131 I by stimulating thyroid globulin level before treatment with131 I were evaluated. Results: There were significant differences in sex,extrathyroid invasion, cervical lymph node metastasis and stimulating thyroglobulin levels before treatment of the ERgroup, the ARgroup and the IR group(P<0.001). The levels of ps-Tg of the IR group were significantly higher than those of the non-IR group(U=1384.5,P<0.001).There was not significant difference between the ER group and the AR group(U=771.5,P=0.326).The ps-Tg thresholds were 28.3 ng/ml in the patients to diagnose IR(The sensitivity was57.5%, the specificity was 87.1%) and the area under the ROC curve(AUC=0.774, 95% CI:0.701-0.847). Conclusion: The level of stimulating thyroglobulin before131 I treatment can predict the clinical outcome of patients with differentiated thyroid cancer at high and middle risk after131 I treatment.

关 键 词：分化型甲状腺癌 131碘 甲状腺球蛋白 临床转归 

分 类 号：R736.1[医药卫生—肿瘤]