血脂及血清IL-6、TSH检测与分化型甲状腺癌患者临床病理特征的关系  

Analysis of the value of blood lipids and serum IL-6 and TSH detection in patients with differentiated thyroid cancer

作　　者：赵凯[1] 崔宁[2] 张虎[3] 周涛[4] 刘迎见[3] Zhao Kai;Cui Ning;Zhang Hu;Zhou Tao;Liu Yingjian(Department of Laboratory Medicine,First People’s Hospital of Shangqiu,Shangqiu 476000,China;Department of Breast Surgery,First People’s Hospital of Shangqiu,Shangqiu 476000,China;Department of Endocrinology,First People’s Hospital of Shangqiu,Shangqiu 476000,China;Department of Nuclear Medicine,First People’s Hospital of Shangqiu,Shangqiu 476000,China)

机构地区：[1]商丘市第一人民医院检验科,商丘476000 [2]商丘市第一人民医院甲乳外科,商丘476000 [3]商丘市第一人民医院内分泌科,商丘476000 [4]商丘市第一人民医院核医学科,商丘476000

出　　处：《中华内分泌外科杂志》2022年第4期441-446,共6页Chinese Journal of Endocrine Surgery

基　　金：河南省医学科技攻关计划项目 (LHGJ20191483)。

摘　　要：目的探究分化型甲状腺癌(differentiated thyroid carcinoma,DTC)患者进行血脂及血清白介素-6(interleukin 6,IL-6)、促甲状腺激素(thyroid stimulating hormone,TSH)检测的价值。方法商丘市第一人民医院甲乳外科2016年3月至2021年10月收治DTC 120例入组DTC组,甲状腺良性结节患者138例入组良性组,并纳入同期在本院体检的健康人群100例入组对照组,检测3组甘油三酯(tri-glyceride,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein,LDL-C)、IL-6、TSH水平并分组比较,纳入有统计学意义的指标进行DTC发生的多因素分析,绘制ROC曲线,计算各指标诊断DTC的灵敏度、特异度及最佳截断值,并分析其与DTC患者临床病理特征的关系。结果血清TSH、IL-6水平从高至低依次为DTC组、良性组、对照组,HDL-C水平从高至低依次为对照组、良性组、DTC组(P<0.05),3组间TC、TG、LDL-C水平比较差异无统计学意义(P>0.05)。多因素Logistics回归分析提示TSH、IL-6可能为DTC发生的危险因素(均OR>1,P<0.05),HDL-C可能为DTC发生的保护因素(OR<1,P<0.05)。绘制ROC曲线,确定TSH诊断DTC的最佳截断值为3.015 mIU/L,AUC:0.985,灵敏度为93.25%,特异度为96.34%,95%CI:0.949~1.000(P<0.001);IL-6诊断DTC的最佳截断值为48.96 ng/L,AUC:0.980,灵敏度为96.98%,特异度为91.53%,95%CI:0.956~1.000(P<0.05);HDL-C诊断DTC的最佳截断值为1.441 mmol/L,AUC:0.0.691,灵敏度为85.10%,特异度为48.06%,95%CI:0.563~0.812(P<0.05)。肿瘤直径>4 cm、乳头状癌的患者与肿瘤直径≤4 cm、滤泡状癌的患者血清TSH、IL-6、HDL-C水平比较均差异无统计学意义(P>0.05)。淋巴结转移(lymph node metastasis,LNM)患者血清TSH、IL-6水平显著高于无LNM患者,HDL-C水平显著低于无LNM患者(P<0.05)。TNM分期为Ⅲ~Ⅳ期的患者血清TSH、IL-6水平显著高于Ⅰ~Ⅱ期的患者,HDL-C显著低于Ⅰ~Ⅱ期的患者(P<0Objective To explore the value of blood lipids,serum interleukin-6(IL-6)and thyroid-stimulating hormone(TSH)detection in patients with differentiated thyroid cancer.Methods From Mar.2016 to Oct.2021,120 cases of DTC were admitted to the DTC group,138 patients with benign thyroid nodules were included in the benign group,and 100 healthy people undergoing the physical examination in our hospital during the same period.were enrolled in the control group.Triglyceride(TG),total cholesterol(TC),high density liptein cholesterol(HDL-C),low density lipoprotein(LDL-C),IL-6,and TSH were compared between groups,and statistically significant indexes were included for multivariate analysis of the occurrence of DTC.The sensitivity,specificity and optimal cut-off value were analyzed,and their relationship with the clinicopathological characteristics of DTC patients was analyzed.Results Serum TSH and IL-6 levels from high to low were malignant group,benign group and control group,and HDL-C levels from high to low were control group,benign group and malignant group(P<0.05).There was no significant difference in the levels of TC,TG or LDL-C(P>0.05).Multivariate Llogistics regression analysis indicated that TSH and IL-6 may be risk factors for the occurrence of differentiated thyroid cancer(all OR>1,P<0.05).HDL-C may be a protective factor for the occurrence of differentiated thyroid cancer(OR<1,P<0.05).The ROC curve was drawn to determine the optimal cut-off value of TSH for the diagnosis of differentiated thyroid cancer,AUC:0.985,sensitivity was 93.25%,specificity was 96.34%,95%CI:0.949-1.000(P<0.001);the best cut-off value of IL-6 for the diagnosis of differentiated thyroid cancer was 48.96 ng/L,AUC:0.980,sensitivity was 96.98%,the specificity was 91.53%,95%CI:0.956-1.000(P<0.05);the best cut-off value of HDL-C for the diagnosis of differentiated thyroid cancer was 1.441 mmol/L,AUC:0.0.691,the sensitivity was 85.10%,the specificity was 48.06%,95%CI:0.563-0.812(P<0.05).The serum levels of TSH and IL-6 in patients with lymph node m

关 键 词：分化型甲状腺癌 甲状腺癌 血脂 促甲状腺激素 白介素-6 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]