血清白介素-6与分化型甲状腺癌术后转移相关性的探讨  

A preliminary study on the correlation between serum IL-6 and postoperative metastasis in patients with differentiated thyroid cancer

作　　者：林禹 赖力[3,4] 陈文新[1,2] LIN Yu;LAI Li;CHEN Wen-xin(Provincial Clinical Medical College of Fujian Medical University,Fuzhou 350001,China;Department of Nuclear Medicine,Fujian Provincial Hospital,Fuzhou 350001,China;Fujian Provincial Key Laboratory of Cardiovascular Disease,Fuzhou 350001,China;Fujian Provincial Hospital Central Laboratory,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院,福建福州350001 [2]福建省立医院核医学科,福建福州350001 [3]福建省心血管病重点实验室,福建福州350001 [4]福建省立医院中心实验室,福建福州350001

出　　处：《中国实验诊断学》2021年第6期817-821,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨血清白介素-6(Interleukin-6,IL-6)与分化型甲状腺癌(Differentiated Thyroid Cancer,DTC)术后转移相关性及其检测意义。方法 DTC行双侧甲状腺全切术后并准备行131I治疗(TSH刺激状态下)的患者43例,按照治疗后5-7天的131I-WBS是否发生转移分为转移组17例,无转移组26例,检测、记录各组131I治疗前血清IL-6、Tg、TgAb、TSH、FT3、FT4水平。结果 (1)DTC术后转移组血清IL-6水平高于无转移组(P=0.043),ROC曲线分析示血清IL-6诊断DTC术后转移的截断值为19.5pg/ml,灵敏度为58.8%,特异度为80.8%,曲线下面积(AUC)为0.680(95%CI 0.507-0.853);DTC术后转移组血清Tg水平高于无转移组(P<0.01),Tg诊断DTC术后转移的临界值为30.2ng/ml,灵敏度为70.6%,特异度为84.6%,AUC为0.822(95%CI 0.697-0.948);IL-6联合Tg检测诊断DTC术后转移的灵敏度为76.5%,特异度为80.8%,AUC为0.835(95%CI 0.698-0.971)。(2)Pearson相关分析示IL-6与年龄、甲状腺功能相关激素不具有相关性。结论血清IL-6水平升高与DTC术后转移相关,并且其不受年龄、甲状腺相关激素的影响,可作为DTC术后转移的有效辅助诊断指标。IL-6与Tg联合检测,可以提高对DTC术后转移的诊断效能。Objective To explore the relationship between serum interleukin-6(IL-6)and postoperative metastasis in patients with differentiated thyroid cancer and its detection significance.Methods Serum IL-6、Tg、TgAb、TSH、FT3、FT4 were detected in 43 DTC patients,underwent total thyroidectomy,who were preparing to receive 131 I therapy.Among them,17 patients were found metastasis after 131I whole-body scan.Results(1)The IL-6 level was significantly higher in the metastasis group than in the non-metastasis group(P=0.043).ROC curve analysis showed that when the cut-off value of IL-6≥19.5 pg/ml,the sensitivity,specificity and area under ROC curve(AUC)(AUC)were58.8%,80.8% and 0.680[95%confidence interval(95%CI)=0.507-0.853].The Tg level was significantly higher in the metastasis group than in the non-metastasis group(P<0.01).ROC curve analysis showed that when the cut-off value of Tg≥30.2 ng/ml,the sensitivity,specificity and AUC were 70.6%,84.6% and 0.822(95%CI 0.697-0.948).ROC curve analysis showed that the sensitivity,specificity and AUC of IL-6 combined with Tg were 76.5%,80.8%and 0.835(95% CI 0.698-0.971).(2)Pearson’s correlation analysis showed that the IL-6 levels was not significantly correlated with age and thyroid function-related hormones.Conclusion Serum IL-6 shows a relationship between elevated concentrations and postoperative metastasis in patients with DTC,and it is not affected by age and thyroid-related hormones.It can be used as a useful auxiliary index for the diagnosis of postoperative DTC metastasis.The combined detection of IL-6 and Tg can improve the diagnostic efficiency of postoperative DTC metastasis.

关 键 词：白介素-6 分化型甲状腺癌 甲状腺球蛋白 抗甲状腺球蛋白抗体 转移 

分 类 号：R736.1[医药卫生—肿瘤]