血清促甲状腺激素水平对甲状腺乳头状癌颈侧淋巴结转移诊断作用分析

Serum hormothyrin level in the diagnosis of lateral cervical lymph node metastasis from papillary thyroid carcinoma

目的探讨血清促甲状腺激素(TSH)水平对甲状腺乳头状癌(PTC)颈侧区淋巴结转移的诊断价值。方法选取2013年2月至2016年4月间新疆医科大学附属肿瘤医院收治的110例PTC患者,同时选取40例甲状腺良性结节患者作为对照,分析患者术前血清TSH与颈侧区淋巴结转移的关系。结果 PTC组患者血清TSH为(2.32±0.61)IU/ml,明显高于甲状腺结节组的(1.42±0.73)IU/ml,差异有统计学意义(P<0.05)。不同性别、年龄和单双侧PTC患者血清TSH比较,差异均无统计学意义(均P>0.05)。肿瘤直径>1cm、Ⅲ~Ⅳ期、有钙化和伴颈侧区淋巴结转移的患者比肿瘤直径≤1cm、Ⅰ~Ⅱ期、无钙化和不伴颈侧区淋巴结转移患者的血清TSH均较高,差异均有统计学意义(均P<0.05)。血清TSH诊断PTC颈侧区淋巴结转移的ROC曲线下面积为0.865,截断值为2.86IU/ml时,灵敏度为75.9%,特异度为81.1%。结论 PTC患者血清TSH水平可作为预测颈侧区淋巴结转移的指标之一。

Objective To investigate the diagnostic value of serum thyroid stimulating hormone（ TSH） level for lymph node metastasis of papillary thyroid carcinoma（ PTC） from lateral cervical region.Methods Select 110 PTC patients and 40 patients with benign thyroid nodules as control at Affiliated Tumor Hospital of Xinjiang Medical University from February 2013 to April 2016. The relationship between preoperative serum TSH and lateral cervical lymph node metastasis was analyzed. Results The serum TSH of was（ 2. 32 ± 0. 61） IU / ml in PTC patients which was obviously higher than（ 1. 42 ± 0. 73） IU / ml of the benign thyroid nodules patients with statistically significant differences（ P 0. 05）. There was no statistically difference in the serum TSH between patients of different types of sex,age and locations of lesion（ P 0. 05）. The serum TSH was higher in patients with tumor diameter 1cm,Ⅲ ~ Ⅳ stage,calcification and lateral cervical lymph node metastasis than in patients with tumor diameter≤1cm,Ⅰ ~ Ⅱstage and without calcification and lateral cervical lymph node metastasis（ P 0. 05）. In the detection of the lateral cervical region lymph node metastasis by serum TSH,the area under the ROC curve was 0. 865,the cutoff value was2. 86 IU / ml,the sensibility was 75. 9% and the specificity 81. 1%. Conclusion Serum TSH level can be one of the indexes to predict lateral cervical region lymph node metastasis in PTC patients