分化型甲状腺癌治疗后TgAb变化趋势及其影响因素

Changes in Thyroglobulin Antibodies after Treatment of Differentiated Thyroid Cancer and Its Influencing Factors

目的探讨分化型甲状腺癌(DTC)中甲状腺球蛋白抗体(TgAb)阳性(>115 U/ml)患者在手术及131I治疗后TgAb的变化趋势及其影响因素。方法纳入118例TgAb阳性患者,分析其手术前、131I治疗前、131I治疗后中位随访2.3个月及5.2个月相应时间点TgAb的变化。采用多元线性回归(MLR)观察患者131I治疗后TgAb下降>50%所需时间(T50)的影响因素。结果与前一时间点的TgAb相比,经手术、131I治疗后中位随访2.3个月和5.2个月TgAb均明显下降(P均=0.000),各阶段降幅>50%者分别占28.6%、33.3%和37.2%,TgAb转阴率分别为23.4%、48.9%和62.8%。MLR显示,T50仅与131I治疗距手术时间(B=1.125,P=0.000)有关。结论手术及131I治疗可明显降低TgAb阳性DTC患者的TgAb水平。131I治疗距手术时间对TgAb下降速度有显著影响,术后尽快行131I治疗有助于TgAb的下降。

Objective To investigate the changes in thyroglobulin antibodies（ TgAb） and its influencing factors in differentiated thyroid cancer（ DTC） patients with positive TgAb（ 115 U / ml） after total thyroidectomy and radioiodine（131I） therapy. Methods We collected the clinical data of 118 DTC patients with positive TgAb and analyzed their TgAb levels before surgery,before131 I therapy,and after131 I therapy with a median follow-up of 2. 3 months and 5. 2 months. Multiple linear regression（ MLR） was applied to analyze the time of TgAb concentration decreased by more than 50%（ T50） and its influencing factors. Results Compared with the previous TgAb levels,TgAb decreased significantly 2. 3 months and 5. 2 months after surgery or after131 Itherapy,respectively（ both P = 0. 000）. The proportions of patients with TgAb decreased by more than 50%in each stage were 28. 6%,33. 3%,and 37. 2%,respectively. The negative conversion ratios were 23. 4%,48. 9%,and 62. 8%,respectively. MLR showed that only the interval between surgery and131 I therapy was correlated with T50（ B = 1. 125,P = 0. 000）. Conclusions The TgAb levels in DTC patients remarkably decrease after surgery and after131 I therapy. The interval between surgery and131 I therapy remarkably influences the lowering speed of TgAb levels. Prompt application of131 I therapy after surgery helps to lower TgAb levels.