甲状腺球蛋白检测在甲状腺结节良恶性鉴别诊断中的价值  

The value of thyroglobulin detection in the differential diagnosis of benign and malignant thyroid nodules

作　　者：张玉萍 尹峰燕[2] 张辉[3] 罗晓婷 曹文源 何倩 邢浩[2] 赵鸿渐 ZHANG Yuping;YIN Fengyan;ZHANG Hui;LUO Xiaoting;CAO Wenyuan;HE Qian;XING Hao;ZHAO Hongjian(School of Clinical and Basic Medicine(Institute of Basic Medicine),Shandong First Medical University,Shandong Jinan 250000,China;Department of Thyroid Surgery,Taian City Central Hospital,Shandong Taian 271000,China;Department of Laboratory Medicine,Taian City Central Hospital,Shandong Taian 271000,China;School of Public Health and Health Management,Shandong First Medical University,Shandong Jinan 250000,China;Department of General Surgery,Chengwu County People's Hospital,Shandong Province,Shandong Chengwu 274200,China)

机构地区：[1]山东第一医科大学临床与基础医学院(基础医学研究所),山东济南250000 [2]泰安市中心医院甲状腺外科,山东泰安271000 [3]泰安市中心医院检验医学科,山东泰安271000 [4]山东第一医科大学公共卫生与健康管理学院,山东济南250000 [5]山东省成武县人民医院普外科,山东菏泽274200

出　　处：《现代肿瘤医学》2025年第5期784-790,共7页Journal of Modern Oncology

基　　金：山东省自然科学基金(编号:ZR2023QH135);山东省泰安市科技创新课题(编号:2022NS234)。

摘　　要：目的:探讨术前血清甲状腺球蛋白(preoperative serum thyroglobulin,PS-Tg)用于甲状腺结节良恶性鉴别诊断的临床价值预测。方法:收集甲状腺结节并行甲状腺切除术者临床及病理资料,Logistic回归分析PS-Tg与甲状腺结节良恶性的关系,绘制列线图将两者关系量化,通过ROC曲线确定最佳截断值。结果:恶性组PS-Tg水平高于良性组(t=7.525,P<0.05),回归分析发现PS-Tg水平升高可能是甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的独立危险因素,且PS-Tg水平升高可解释约55%的PTC风险。采用ROC曲线下面积评估PS-Tg预测甲状腺结节良恶性的AUC为0.7075,男性和女性预测AUC分别为0.5904、0.7337。结论:PS-Tg水平升高可能是PTC患者的危险因素,并且女性人群相比男性人群对甲状腺结节良恶性诊断有更好的预测价值。Objective:To investigate the clinical value of preoperative serum thyroglobulin(PS-Tg)in differential diagnosis between benign and malignant thyroid nodules.Methods:Collect clinical and pathological data of patients undergoing thyroidectomy,perform logistic regression analysis on the relationship between PS-Tg and benign and malignant thyroid nodules,draw a nomogram to quantify the relationship between the two,and determine the optimal cutoff value through the ROC curve.Results:The levels of PS-Tg in the malignant group were higher than those in the benign group(t=7.525,P<0.05).Regression analysis revealed that an increase in PS-Tg levels may be an independent risk factor of papillary thyroid carcinoma(PTC),and an increase in PS-Tg levels can explain approximately 55%of the PTC risk.The area under the ROC curve was used to evaluate the AUC of PS-Tg for predicting benign and malignant thyroid nodules,which was 0.7075.The AUC for males and females were 0.5904 and 0.7337,respectively.Conclusion:Elevated PS-Tg levels may be a risk factor for PTC patients,and the female population has good predictive value for the diagnosis of benign and malignant thyroid nodules compared to the male population.

关 键 词：甲状腺球蛋白 甲状腺结节 甲状腺乳头状癌 诊断价值 预测 

分 类 号：R736.1[医药卫生—肿瘤]