血清TgAb、TPOAb、TSH检测在良恶性甲状腺结节鉴别诊断中的临床意义  

Clinical significance of serum TgAb,TPOAb and TSH detection in differential diagnosis of benign and malignant thyroid nodules

作　　者：汪慧芸[1] Wang Huiyun(Department of Clinical Laboratory,Jiangyin Hospital of Traditional Chinese Medicine,Jiangyin 214400,Jiangsu,China)

机构地区：[1]江苏省江阴市中医院检验科,江苏江阴214400

出　　处：《右江民族医学院学报》2021年第1期96-98,116,共4页Journal of Youjiang Medical University for Nationalities

摘　　要：目的探讨血清甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、促甲状腺激素(thyroid stimulating hormone,TSH)检测在良恶性甲状腺结节鉴别诊断中的临床意义。方法选取148例手术治疗的甲状腺结节患者为研究对象,将术后病理结果为良性甲状腺结节的86例患者作为良性组,病理结果为甲状腺癌的62例患者作为恶性组。检测两组患者TgAb、TPOAb、TSH水平并进行比较;检测TgAb、TPOAb、TSH各单项和3项联合的检测阳性率及准确度、灵敏度和特异性并进行比较,确定各指标的诊断效率。结果恶性组TgAb、TPOAb、TSH水平均明显高于良性组,差异具有统计学意义(P<0.001);恶性组的TgAb、TPOAb、TSH各单项和3项联合的阳性检出率分别为32.26%、45.16%、40.32%、83.87%,均明显高于良性组13.95%、24.42%、23.26%、25.58%,差异具有统计学意义(P<0.05)。3项联合检测的阳性检出率高于各单项检测的阳性检出率;TgAb、TPOAb、TSH联合检测的准确度、灵敏度分别为78.38%、83.87%,高于各单项测定(P<0.01),其特异性差异无统计学意义(P>0.05)。结论恶性甲状腺结节患者的TgAb、TPOAb、TSH含量处于较高水平,TgAb、TPOAb、TSH各单项和3项联合检测的阳性检出率高于良性组,且具有较高的准确度和灵敏度,可作为临床判断良恶性甲状腺结节的参考指标。Objective To investigate the clinical significance of detecting serum thyroglobulin antibody(TgAb),thyroid peroxidase antibody(TPOAb)and thyroid stimulating hormone(TSH)in the differential diagnosis of benign and malignant thyroid nodules.Methods A total of 148 patients with thyroid nodules treated by surgery were selected as research subjects.86 patients with postoperative pathological result of benign thyroid nodule were selected as the benign group,and 62 patients with pathological result of thyroid cancer were selected as the malignant group.We detected and compared the levels of TgAb,TPOAb and TSH in two groups.Lastly,we detected and compared the positive rate,accuracy,sensitivity and specificity of TgAb,TPOAb,TSH and combination of three indicators,respectively,to determine the diagnostic efficiency of each indicator.Results The levels of TgAb,TPOAb and TSH in the malignant group were significantly higher than those in the benign group,and the differences were statistically significant(P<0.001);The positive rates of TgAb,TPOAb,TSH and combination of three indicators in the malignant group were 32.26%,45.16%,40.32%and 83.87%,respectively,which were significantly higher than those in the benign group(13.95%,24.42%,23.26%,25.58%),and the difference was statistically significant(P<0.05).The positive rate of combination of three indicators was higher than that of each single indicator.The accuracy and sensitivity of combination of TgAb,TPOAb and TSH were 78.38%and 83.87%,respectively,which were significantly higher than those of single indicator(P<0.01),while there was no significant difference in specificity between them(P>0.05).Conclusion The levels of TgAb,TPOAb and TSH in patients with malignant thyroid nodules are higher.And their positive rates of each single indicator and combination of TgAb,TPOAb and TSH are all higher than those of the benign group,with higher accuracy and sensitivity,which can be used as a reference indicator for clinical diagnosis of benign and malignant thyroid nodules.

关 键 词：甲状腺结节 甲状腺球蛋白抗体 甲状腺过氧化物酶抗体 促甲状腺激素 鉴别诊断 

分 类 号：R581[医药卫生—内分泌]