甲状腺球蛋白联合甲状腺球蛋白抗体及促甲状腺素对分化型甲状腺癌病人预后的预测价值  

Prognostic value of the detection of thyroglobulin combined with thyroglobulin antibody in patients with differentiated thyroid cancer

作　　者：张超[1] 李娟娟[1] 姚廷敬[1] ZHANG Chao;LI Juan-juan;YAO Ting-jing(Department of Oncology,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院肿瘤外科,安徽蚌埠233004

出　　处：《蚌埠医学院学报》2023年第9期1219-1222,共4页Journal of Bengbu Medical College

基　　金：安徽省蚌埠市科技创新指导项目(20200350)。

摘　　要：目的:探讨血清甲状腺球蛋白与甲状腺球蛋白抗体联合检测预测甲状腺癌病人预后的价值。方法:选取行甲状腺癌手术病人180例,术后随访2年,按随访结果分为预后良好组141例和预后不良组39例,比较2组病人术后淋巴结转移、原发灶情况等临床病理特征和术前甲状腺素、促甲状腺素、甲状腺球蛋白、甲状腺球蛋白抗体等甲状腺功能相关指标,采用多因素logistic回归模型分析甲状腺癌病人预后影响因素,ROC曲线分析预后指标的临床预测价值。结果:预后不良组病人原发灶T 3/T 4期、淋巴结多发转移比例和血清促甲状腺素、甲状腺球蛋白、甲状腺球蛋白抗体水平均高于预后良好组(P<0.05~P<0.01);多因素logistic回归分析显示,高甲状腺球蛋白、促甲状腺素、甲状腺球蛋白抗体和原发肿瘤T分期T 3/T 4期及多发淋巴结转移均为病人预后的独立危险因素(P<0.05~P<0.01);ROC曲线分析显示,血清甲状腺球蛋白、甲状腺球蛋白抗体、促甲状腺素及三者联合预测病人预后的AUC分别为0.878、0.831、0.811、0.978,三者联合预测价值高于单项指标(P<0.01)。结论:甲状腺球蛋白、甲状腺球蛋白抗体联合促甲状腺素对分化型甲状腺癌病人预后具有较好的预测价值。Objective:To explore the value of the detection of serum thyroglobulin combined with thyroglobulin antibody in predicting the prognosis of patients with thyroid cancer.Methods:One hundred and eighty patients treated with thyroid cancer surgery were selected,and followed up for 2 years after surgery.According to the following-up results,the patients were divided into the good prognosis group(141 cases)and poor prognosis group(39 cases),and the clinicopathological characteristics(lymph node metastasis and primary focus)after surgery and preoperative thyroid hormone,thyrotropin,thyroglobulin,anti-thyroid autoantibodies and other thyroid function related indicators were compared between two groups.The multivariate logistic regression model analysis was used to analyze the prognostic factors,and the ROC curve was used to analyze the clinical predictive value of prognostic indicators.Results:The proportions of stage T 3/T 4 of primary focus and multiple lymph node metastasi,and serum levels of thyrotropin,thyroglobulin and thyroglobulin antibody in the poor prognosis group were higher than those in good prognosis group(P<0.05 to P<0.01).The results of multivariate logistic regression analysis showed that the high thyroglobulin,high thyrotropin,high anti-thyroid autoantibodies,stage T 3/T 4 of primary focus and multiple lymph node metastasis were the independent risk factors of the prognosis of patients(P<0.01).The results of ROC curve analysis showed that the AUC of serum thyroglobulin,thyroglobulin antibody,thyrotropin and their combination in predicting the prognosis of patients were 0.878,0.831,0.811 and 0.978,respectively,and the combined prediction value of three indexes was higher than that of single index(P<0.01).Conclusions:The detection of thyroglobulin,thyroglobulin antibody combined with thyrotropin have good prognostic value in differentiated thyroid cancer patients.

关 键 词：甲状腺癌 甲状腺球蛋白 甲状腺球蛋白抗体 促甲状腺素 预后 

分 类 号：R736.1[医药卫生—肿瘤]