血清KLK11、MK水平与分化型甲状腺癌术后首次^(131)I清甲效果的关系研究  

Relationship between serum KLK11 and MK levels and the efficacy of the first^(131)I ablation after surgery for differentiated thyroid cancer

作　　者：郭建军[1] 严鸣光[1] 田红英 方晓[1] 贾雷鸣 崔宁[2] Guo Jianjun;Yan Mingguang;Tian Hongying;Fang Xiao;Jia Leiming;Cui Ning(Department of Laboratory Medicine,Shangqiu First People’s Hospital,Shangqiu 476000,China;Department of Thyroid and Breast Surgery,Shangqiu First People’s Hospital,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状腺乳腺外科,商丘476000

出　　处：《中华内分泌外科杂志》2022年第5期584-588,共5页Chinese Journal of Endocrine Surgery

基　　金：河南省医学科技攻关计划(2018020947)。

摘　　要：目的探讨分析血清组织激肽释放酶11(kallikrein-related peptidases 11,KLK11)、中期因子(midkine,MK)水平与分化型甲状腺癌(differentiated thyroid cancer,DTC)术后首次^(131)I清除术后残留甲状腺组织(简称"清甲")效果的关系。方法回顾性分析2020年6月至2021年6月商丘市第一人民医院甲状腺乳腺外科108例DTC预行甲状腺全切除术,且术后进行放射性清甲治疗,男37例,女71例;年龄(48.32±4.25)岁,范围为28~79岁。根据治疗后是否清甲成功将患者分为清甲成功组64例和清甲未成功组44例,并选取同期本院体检无异常的60例健康者作为对照组。是否发生淋巴结转移,将患者分为转移阳性组20例和转移阴性组88例。清甲治疗后第二天取所有研究对象血清标本,采用酶联免疫吸附法检测其血清KLK11、MK水平,搜集患者性别、年龄、体重指数(body mass index,BMI)、TNM分期、促甲状腺素(thyroid stimulating hormone,TSH)、病灶最大径、清甲治疗时间,统计数据采用SPPS 21.0软件,采用单因素对一般资料进行分析,然后对有统计意义的因素进行Logistic回归多因素分析影响术后疗效的独立危险因素。结果清甲成功组和清甲未成功组血清KLK11、MK水平高于对照组(KLK11:t=5.129、7.832,P<0.05;MK:t=7.799、15.978,P<0.05),而清甲未成功组血清KLK11、MK水平高于清甲成功组(KLK11:t=2.642,P<0.05;MK:t=11.906,P<0.05)。转移阳性组血清KLK11、MK水平高于转移阴性组(KLK11:t=2.908,P<0.05;MK:t=14.907,P<0.05)。单因素分析结果显示,BMI(χ^(2)=6.780,P=0.009)、病灶最大径(χ^(2)=14.819,P=0.001)、TSH(χ^(2)=13.627,P=0.001)、血清KLK11(t=2.642,P=0.01)、血清MK(t=11.906,P<0.001)与DTC术后首次^(131)I清甲效果有关(P<0.05)。以清甲成功为因变量,进行多因素Logistic回归分析,结果显示病灶最大径>2 cm(OR=10.740,95%CI:7.033~16.401)、TSH水平升高(OR=8.559,95%CI:2.812~26.057)、血清KLK11水平升高(OR=16.710,95%CI:8.548~32.666)、血清MK水平Objective To explore and analyze the relationship between serum KLK11 and MK levels and the effect of first iodine 131(^(131)I)ablation after operation for differentiated thyroid cancer.Method 108 patients with differentiated thyroid cancer who underwent total thyroidectomy in our hospital from Jun.2020 to Jun.2021 were consecutively selected,and received radioactive ablation after surgery.There were 37 males and 71 females.The age was(48.32±4.25)years,ranging from 28 to 79 years.The patients were divided into successful ablation according to whether the ablation was successful after treatment.There were 64 cases in the group and 44 cases in the unsuccessful group,and 60 healthy people with no abnormality in physical examination during the same period were selected as the control group.The patients were divided into a metastasis-positive group of 20 cases and a metastasis-negative group of 88 cases according to whether lymph nodes occurred.After surgery,serum samples of all subjects were taken,and enzyme-linked immunosorbent assay was used to detect the levels of serum kallikrein-related peptidases 11(KLK11)and midkine(MK),and the levels of serum KLK11 and MK were analyzed.Gender,age,BMI,TNM stage,TSH,maximum diameter of lesion,and duration of nail removal were collected.Univariate analysis and logistic regression analysis were used to analyze the independent risk factors of postoperative efficacy.Result The levels of serum KLK11 and MK in the successful and unsuccessful groups were higher than those in the control group,while the levels of KLK11 and MK in the unsuccessful group were higher than those in the successful group(KLK11:t=2.642,P<0.05;MK:t=11.906,P<0.05).The serum levels of KLK11 and MK in the metastasis-positive group were higher than those in the metastasis-negative group(KLK11:t=2.908,P<0.05;MK:t=14.907,P<0.05).Univariate analysis showed that BMI(χ^(2)=6.780,P=0.009),maximum diameter of lesions(χ^(2)=14.819,P=0.001),TSH(χ^(2)=13.627,P=0.001),serum KLK11(t=2.642,P=0.01),and serum MK(t=11.906,P<0.

关 键 词：甲状腺癌 组织激肽释放酶11 中期因子 分化型甲状腺癌 ^(131)碘治疗 

分 类 号：R736.1[医药卫生—肿瘤]