A-Tg、Tg减少指数对中低危分化型甲状腺癌患者术后首次^(131)I清甲疗效的预测价值  

Predictive Value of A-Tg and Tg Reduction Index on the Efficacy of Postoperative First ^(131)I Therapy in Patients with Low-to-moderate Risk Differentiated Thyroid Darcinoma

作　　者：杜帅格 王朝栋 苌哲宗 石翔 王耀飞 DU Shuaige;WANG Chaodong;CHANG Zhezong(General Hospital of Pingmei Shenma Group,Pingdingshan,467000)

机构地区：[1]平煤神马医疗集团总医院,467000

出　　处：《实用癌症杂志》2024年第5期863-866,共4页The Practical Journal of Cancer

摘　　要：目的探讨甲状腺球蛋白抗体(A-Tg)、甲状腺球蛋白(Tg)减少指数对术后^(131)I治疗的中低危分化型甲状腺癌(DTC)患者疗效的预测价值。方法回顾108例中低危分化型DTC患者资料,所有患者均接受甲状腺癌根治术+术后^(131)I治疗。根据患者首次^(131)I治疗疗效分为成功组(88例)和失败组(20例),比较2组患者一般资料、A-Tg、Tg减少指数。采用ROC曲线、logistic回归分析A-Tg、Tg减少指数对疗效的预测效能,spearman相关系数分析与疗效的关系。结果2组患者的A-Tg、Tg减少指数、性别、肿瘤直径、AJCC分期比较,差异有统计学意义(P<0.05);年龄、手术方式、治疗剂量比较无统计学意义(P>0.05)。A-Tg、Tg减少指数及联合检测预测预后的AUC分别为0.755、0.844、0.882,敏感度分别为70.00%、90.00%、90.00%,特异度分别为77.27%、75.00%、76.14%。不同疗效患者A-Tg、Tg减少指数比较,差异有统计学意义(P<0.05);A-Tg越高疗效越差,Tg减少指数越高疗效越好。Logistic回归分析显示,A-Tg、Tg减少指数、AJCC分期为DTC患者首次^(131)I治疗中低危DTC患者疗效的独立影响因素(P<0.05)。结论检测A-Tg、Tg减少指数可预测中低危DTC患者术后首次^(131)I治疗效果,而且二者联合预测的效能更佳,能为此后治疗提供指导。Objective To explore the predictive value of early thyroglobulin antibody(A-Tg)and thyroglobulin(Tg)reduction index on the efficacy of postoperative ^(131)I therapy in patients with low-to-moderate risk differentiated thyroid carcinoma(DTC).Methods The data of 108 patients with low-to-moderate risk differentiated DTC who received treatment were reviewed.All patients received radical resection of thyroid carcinoma+postoperative ^(131)I therapy.Patients were divided into success group(88 cases)and failure group(20 cases)according to the efficacy of first ^(131)I therapy.General data,A-Tg and Tg reduction index were compared among the patients.ROC curve and logistic regression analysis were used to analyze the predictive efficiency of the above indicators on the efficacy,and spearman correlation coefficient was used to analyze the relationship with efficacy.Results There were statistically significant differences in A-Tg,Tg reduction index,gender,tumor diameter and AJCC staging among patients with different efficacies(P<0.05),but there were no statistical differences in age,surgical method and therapeutic dose(P>0.05).The AUCs of A-Tg,Tg reduction index and combined detection on predicting the prognosis were 0.755,0.844 and 0.882,and the sensitivities were 70.00%,90.00% and 90.00%,and the specificities were 77.27%,75.00% and 76.14% respectively.Comparisons of A-Tg and Tg reduction index in patients with different efficacies showed statistical differences(P<0.05).The higher A-Tg,the worse the efficacy,and the higher the Tg reduction index,the better the efficacy.Logistic regression analysis showed that A-Tg,Tg reduction index and AJCC staging were independent influencing factors for the efficacy of the first ^(131)I therapy in patients with low-to-moderate risk DTC(P<0.05).Conclusion Detection of A-Tg and Tg reduction index in patients with low-to-moderate risk DTC can help predict the effect of postoperative first ^(131)I therapy,and the combination of the two has better efficiency,and can provide guidance for futur

关 键 词：甲状腺球蛋白抗体 甲状腺球蛋白减少指数 中低危分化型甲状腺癌 131碘治疗 

分 类 号：R736.1[医药卫生—肿瘤]