消融前刺激性甲状腺球蛋白对分化型甲状腺癌合并结节性甲状腺肿复发或转移的诊断价值  

Diagnostic value of preablative stimulated thyroglobulin for recurrence or metastases of differentiated thyroid carcinoma complicated with nodular goitre

作　　者：柴红[1] 黄琴[1] 陈泽泉[1] 杨佳欢 余永利[1] CHAI Hong;HUANG Qin;CHEN Ze-quan;YANG Jia-huan;YU Yong-li(Department of Nuclear Medicine,Shanghai Sixth People's Hospital,Shanghai Jiao Tong University,Shanghai 201306,China)

机构地区：[1]上海交通大学附属第六人民医院核医学科,上海201306

出　　处：《上海交通大学学报（医学版）》2021年第5期617-621,共5页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市卫生和计划生育委员会科研课题(20164Y0202)。

摘　　要：目的·在分化型甲状腺癌(differentiated thyroid carcinoma,DTC)合并结节性甲状腺肿(nodular goitre,NG)患者中,评估术后碘消融前促甲状腺素(thyroid stimulating hormone,TSH)刺激性甲状腺球蛋白(preablative stimulated thyroglobulin,ps-Tg)作为早期预后指标的作用,确定ps-Tg预测该病复发或转移的最佳截断值。方法·回顾性分析接受甲状腺全切术和放射性^(131)I治疗的268例DTC合并NG患者的病例资料。采用Logistic回归分析评价ps-Tg和其他临床病理特征在术后早期阶段肿瘤远处转移中的预测意义。通过受试者操作特征(receiver operating characteristic,ROC)曲线分析,确定在DTC合并NG患者中ps-Tg预测复发或转移的最佳临界点。结果·Logistic分析结果显示,ps-Tg(OR=1.002,P=0.005)、N_(1b)(OR=0.235,P=0.001)和组织病理类型(OR=0.263,P=0.012)是肿瘤远处转移的预测因子。ps-Tg预测疾病复发或转移的最佳截断值为26.97 ng/mL,敏感度和特异度分别为66.7%和83.3%,ROC曲线下面积为0.795。结论·对于DTC合并NG患者,ps-Tg、N_(1b)和组织病理类型对术后早期肿瘤复发或转移有重要预测意义;Ps-Tg的截断值有助于预测肿瘤的复发或转移。Objective·To evaluate the role of preablative stimulated thyroglobulin(ps-Tg)as an early prognostic marker for patients with differentiated thyroid carcinoma(DTC)complicated with nodular goitre(NG)after operation and determine the corresponding cut-off value.Methods·A total of 268 patients with DTC complicated with NG who underwent the ^(131)I treatment and thyroidectomy were analyzed.Logistic regression analysis were performed to evaluate baseline ps-Tg and other clinicopathologic characteristics in the prediction of distant metastasis.The receiver operating characteristic(ROC)curve analysis was conducted to analyze optimal cut-off point of ps-Tg for predicting the recurrence or metastasis for patients with DTC complicated with NG.Results·In the Logistic analysis,ps-Tg(OR=1.002,P=0.005),N_(1b)(OR=0.235,P=0.001)and the histological-pathological types(OR=0.263,P=0.012)were predictors of distant metastasis.The cut-off value of ps-Tg for predicting the recurrence or metastasis was 26.97 ng/mL,with sensitivity of 66.7%and specificity of 83.3%.Area under the ROC curve was 0.795.Conclusion·For patients with DTC complicated with NG,ps-Tg,N_(1b) and the histological-pathological types have a significant prognostic implication in early postoperative metastasis or recurrence.The cut off value of ps-Tg could be more useful for the prediction of metastasis or recurrence.

关 键 词：分化型甲状腺癌 结节性甲状腺肿 消融前刺激性甲状腺球蛋白 

分 类 号：R736.1[医药卫生—肿瘤]