TgAb水平预测TgAb阳性分化型甲状腺癌患者^(131)I治疗后病灶转移的价值分析

The value analysis of TgAb level in predicting metastasis of TgAb positive differentiated thyroid cancer after 1311 treatment

目的观察抗甲状腺球蛋白抗体(TgAb)阳性分化型甲状腺癌(DTC)患者^(131)I治疗后血清TgAb水平的变化趋势,探讨TgAb水平变化对转移灶的预测价值。方法回顾性分析158例^(131)I治疗前TgAb阳性的DTC患者的临床资料,根据^(131)I治疗后随访1年时TgAb水平,分为TgAb转阴组和未转阴组,比较两组患者的病灶转移率,观察确诊转移与未转移患者的血清TgAb水平变化趋势。结果TgAb未转阴组的转移率明显高于TgAb转阴组,差异有统计学意义(P=0.002)。TgAb水平升高组与稳定组的转移发生率大致相仿,且高于TgAb水平下降组,但三组间差异无统计学意义(P=0.600)。进一步研究发现,19例确诊转移与139例未转移患者^(131)I治疗后血清TgAb水平变化趋势比较,差异有统计学意义(P=0.002)。结论当血清甲状腺球蛋白(Tg)阴性时,TgAb水平可作为TgAh阳性DTC患者^(131)I治疗后预测转移的监测指标。

Objective To observe the change trend of serum TgAb level in TgAb positive patients after ^(131)I treatment,and to explore the predictive value of TgAb level change in metastasis.Methods Clinical data of 158 cases of TgAb positive DTC patients admitted to our hospital before ^(131)I treatment were retrospectively analyzed.According to the TgAb level after ^(131)I treatment for 1 year,they were divided into the TgAb negative group and the TgAb non-negative group.At the same time,serum TgAb levels in patients with confimied metastasis and those without metastasis were observed.Results The metastatic rate of the TgAb non-negative group was significantly higher than that of the TgAb negative group,and the difference was statistically significant(P=0.002).The incidence of metastasis in the elevated TgAb group was roughly similar to that in the stable group,and higher than that in the decreased TgAb group,but there was no statistical significance between the three groups(P=0.600).Further study found that there was a statistically significant difference in the trend of serum TgAb level after ^(131)I treatment in 19 patients with confirmed metastasis and 139 patients without metastasis(P=0.002).Conclusion When serum Tg is negative,TgAb level can be used as a monitoring index to predict metastasis after 1,11 treatment in TgAb positive DTC patients.