血清癌胚抗原、甲状腺球蛋白及半乳凝集素-3水平在甲状腺癌鉴别诊断中的价值

The value of serum carcinoembryonic antigen, thyroglobulin and galectin-3 in differential diagnosis of thyroid cancer

目的探讨血清中癌胚抗原(CEA)、甲状腺球蛋白(Tg)及半乳凝集素-3(gal-3)在甲状腺癌鉴别诊断中的价值。方法选取我院经病理学明确诊断的甲状腺癌患者127例(甲状腺癌组)、甲状腺良性结节患者(良性组)60例,收治时间2015年1月至2017年9月,检测并对比2组患者的血清CEA、Tg及gal-3水平,以病理学结果作为诊断金标准,计算诊断学指标。结果甲状腺癌患者的血清CEA、Tg及gal-3水平均显著高于良性组,差异具有统计学意义(P<0.05);当血清CEA为5.00 ng/mL时,CEA诊断甲状腺癌的灵敏度为26.98%,特异度为87.40%,ROC曲线下面积AUC值为0.608;当血清Tg为65.40 ng/mL时,Tg诊断甲状腺癌的灵敏度为30.17%,特异度为89.21%,ROC曲线下面积AUC值为0.629;当血清gal-3为19.67 ng/mL时,gal-3诊断甲状腺癌的灵敏度为72.85%,特异度为85.64%、ROC曲线下面积AUC值为0.761;血清CEA、Tg及gal-3诊断甲状腺癌的灵敏度为87.92%,特异度为94.18%,ROC曲线下面积AUC值为0.916。结论血清CEA、Tg及gal-3联合诊断甲状腺癌较3项指标单独应用具有更高的临床价值。

Objective To investigate the clinical value of serum carcinoembryonic antigen(CEA),thyroglobulin(Tg) and galectin-3(gal-3) in the differential diagnosis of thyroid cancer. Methods 127 patients with thyroid cancer diagnosed by pathology(thyroid cancer group) and 60 patients with benign thyroid nodules(benign group) were recruited. The patients were treated from January 2015 to September 2017.Serum levels of CEA, Tg, and gal-3 were calculated using pathological results as diagnostic gold standards.Results Serum levels of CEA, Tg and gal-3 in patients with thyroid cancer were significantly higher than those in benign group(P<0.05). When the serum CEA was 5.00 ng/mL, the sensitivity of CEA in diagnosing thyroid cancer was 26.98%, the specificity was 87.40%, and the area under the ROC curve was 0.608. When the serum Tg was 65.40 ng/mL, the sensitivity and specificity of Tg for diagnosing thyroid cancer were 30.17%and 89.21%, respectively. The AUC value under the ROC curve was 0.629. When serum gal-3 was 19.67 ng/mL, the sensitivity of diagnosis of thyroid cancer was 72.85%, the specificity was 85.64%, the area under the ROC curve was 0.761. The sensitivity and specificity of serum CEA, Tg、gal-3 in the diagnosis of thyroid cancer were 87.92% and 94.18%, respectively. The area under the ROC curve was 0.916. Conclusion The clinical value of the combination of CEA, TG and gal-3 was significantly higher than the single indicator.