血清甲状腺球蛋白在分化型甲状腺癌术后转移的诊断预测效能分析  

Diagnostic and predictive efficacy of serum ps-Tg in postoperative metastasis of DTC

作　　者：赵连春[1] 刘光霞[2] 陈芳[2] 牛丽霞 ZHAO Lian-chun;LIU Guang-xia;CHEN Fang;NIU Li-xia(Department of Clinical Laboratory,Yiling Hospital,Shijiazhuang,Hebei 050091;Department of Nuclear Medicine,Hebei Provincial People′s Hospital,Shijiazhuang,Hebei 050051,China)

机构地区：[1]河北以岭医院检验科,河北石家庄050091 [2]河北省人民医院核医学科,河北石家庄050051

出　　处：《热带医学杂志》2020年第12期1569-1572,共4页Journal of Tropical Medicine

基　　金：以岭实验研究计划项目(GHI-2016458145)。

摘　　要：目的分析刺激性甲状腺球蛋白(ps-Tg)对分化型甲状腺癌(DTC)术后转移的诊断预测效能。方法选取2017年1月至2019年2月河北以岭医院检验科和河北省人民医院核医学科收治的127例DTC患者临床资料进行分析,均停服甲状腺素片4~6周,131碘(131I)治疗1 d前测ps-Tg水平,131I治疗后1周内进行131I-SPECT/CT显像。根据131I-SPECT/CT显像判定是否存在功能性转移灶分为转移组(n=49)和无转移组(n=61)。采用全自动电化学发光分析仪检测两组患者ps-Tg水平,并通过ROC曲线评估ps-Tg水平预测功能性转移的价值。结果131I治疗前转移组ps-Tg水平显著高于无转移组[(240.36±55.32)ng/mL vs.(5.32±3.85)ng/mL](t=33.121,P<0.001),治疗后转移组psTg水平(89.12±13.32)ng/mL较治疗前明显降低(t=-18.606,P<0.05),差异均有统计学意义。血清ps-Tg水平在各转移分级中,随着转移部位分级提高,血清ps-Tg水平逐渐增高,差异有统计学意义(F=752.87,P<0.001)。经Spearman等级相关分析可知ps-Tg与DTC术后转移分级呈正相关(r=0.608,P<0.05)。ps-Tg值的ROC曲线下面积为0.859,诊断界值为40.70 ng/mL,敏感度、特异度、准确度分别为76.37%、85.70%、87.63%。结论血清ps-Tg水平检测可辅助诊断预测DTC术后转移,评估DTC复发、转移分层状况,指导131I治疗决策。Objective To explore the diagnostic and predictive efficacy of serum thyroglobulin(ps-Tg) in the post-operation of differentiated thyroid carcinoma(DTC).Methods From January 2017 to February 2019,the clinical data of 127 patients with DTC admitted to the Department of Laboratory,Yiling Hospital of Hebei Province and the Department of Nuclear Medicine,Hebei Provincial People’ s Hospital were analyzed.Thyroxine tablets were stopped taking for 6 weeks.PsTg level was measured one day before 131I treatment and 131I-SPECT/CT imaging was performed within one week after 131I treatment.According to 131I-SPECT/CT imaging,the presence of functional metastasis was determined and divided into metastasis group and non-metastasis group.The ps-Tg levels of the two groups were measured,and the value of ps-Tg level in predicting functional metastasis was evaluated by ROC curve.Results The level of ps-Tg in the metastasis group before 131I treatment was significantly higher than that in the non-metastasis group [(240.36±55.32) ng/mL vs.(5.32±3.85) ng/mL](t=33.121,P<0.001),the ps-Tg level after 131I treatment was significantly low than that of before treatment(t=-18.606,P<0.05).Serum ps-Tg level in each metastasis grade,as the metastasis site and grade increased,serum ps-Tg level gradually increased,with significant difference(F=752.87,P<0.001).The Spearman grade correlation analysis showed that ps-Tg was positively correlated with the grade of postoperative metastasis of DTC(r=0.608,P<0.05).The area under the ROC curve of the ps-Tg value was 0.859,the diagnostic cut-off value was 40.70 ng/mL,and the sensitivity,specificity,and accuracy were76.37%,85.70%,and 87.63%,respectively.Conclusion Serum ps-Tg level detection could assist in the diagnosis and prediction of postoperative DTC metastasis,evaluate DTC recurrence and metastasis status,and guide 131I treatment decision.

关 键 词：甲状腺肿瘤 甲状腺切除术 甲状腺球蛋白 肿瘤转移 

分 类 号：R736.1[医药卫生—肿瘤]