细胞角蛋白多肽-19水平对新发甲状腺乳头状癌患者预后的影响

Predictive value of cytokeratin polypeptide 19 level on prognosis of patients with first occurrence of papillary thyroid carcinoma

目的探讨细胞角蛋白多肽-19（CK19）水平对新发甲状腺乳头状癌（P，rc）患者预后的影响。方法选择60例PTC患者，根据PTC是否复发分为复发组（27例）与非复发组（33例），测定并比较两组患者的CK19水平和临床资料。结果单因素分析结果显示，两组年龄、女性、吸烟史、毒性弥漫性甲状腺肿病史、职业暴露史、甲状腺过氧化物酶抗体（TPOAb）水平、甲状腺球蛋白抗体（TGAb）水平、三酰甘油（TG）水平及CK19水平比较差异有统计学意义（P〈0．05）。多因素Logistic回归分析结果显示，女性、吸烟史、职业暴露史、TPOAb水平升高、TGAb水平升高、CK19水平升高是患者12个月内PTC复发的独立危险因素（P=0．01）。CK19≥4．12μg／L患者复发率为79．31％（23／29），显著高于CK19〈4．12μg／L患者的12．90％（4／31），差异有统计学意义（r=5．17，P〈0．05）。CK19≥4．12IJ-g／L时，PTC复发率较CK19〈4．12μg／L时显著增加（r=4．11，P〈0．05）。结论CK19水平升高是PTC患者复发的独立危险因素，可对新发PTC患者复发情况进行有效预测。

Objective To determine the relationship between plasma cytokeratin polypeptide 19 （CK 19 ） level and prognosis of patients with first occurrence of papillary thyroid carcinoma （PTC）. Methods This prospective trial enrolled 60 patients with PTC. The plasma CK19 level was determined by ELISA and the other clinical data were collected on admission. All patients were followed up for 12 months. The patients were divided into recurrence group （27 patients ） and non- recurrence group （33 patients） according to the results of follow-up. Results Single factor analysis showed that age, female, history of smoking, Graves disease, occupational exposure, the level of thyroid peroxidase antibody, thyroglobulin antibody, triglyceride and CK19 between two groups had significant difference （P 〈 0.05）. Multiple factors analysis showed that female, history of smoking, occupational exposure, the level of thyroid peroxidase antibody, thyroglobulin antibody and CK19 were independent risk factors for recurrence （P = 0.01 ）. The recurrence rate of CK1≥ 4.12 μg/L patients was 79.31% （23/29）,significantly higher than that in CK19 〈4.12 μg/L patients [ 12.90% （4/31 ） ] （ X2 = 5.17, P 〈 0.05 ）. The recurrence rate of C K 19 I〉 4,12 μg/L was significantly higher than that in CK19 〈4.12 μg/L （ X2 =4.11,P 〈0.05）. Conclusions The plasma CK19 level is an independent risk factor for recurrence of PTC patients. It can be used as a significant independent predictor for recurrence of PTC patients.