Tg、TSH水平变化对分化型甲状腺癌患者诊断的价值分析

Diagnostic Value of Tg and TSH in Differentiated Thyroid Carcinoma

目的探讨甲状腺球蛋白(Tg)、促甲状腺激素(TSH)水平对分化型甲状腺癌的诊断价值。方法选取2018年3月-2020年8月在如皋博爱医院及如皋市人民医院接受治疗的56例分化型甲状腺癌患者为观察组,并选取同期诊治的56例甲状腺良性结节患者为对照组,比较两组患者血清Tg、TSH水平以及其阳性检出率、不同诊断指标诊断准确性、敏感性、特异性。结果观察组TSH水平及阳性率均高于对照组,差异有统计学意义(P<0.05),两组患者的Tg水平及阳性率比较,差异无统计学意义(P>0.05);TSH诊断分化型甲状腺癌准确性、敏感性、特异性分别为80.72%、85.58%、65.84%,均高于甲状腺良性结节的45.27%、26.33%、46.96%,差异有统计学意义(P<0.05);Tg诊断诊断分化型甲状腺癌准确性、敏感性、特异性分别为54.53%、52.32%、56.24%,与甲状腺良性结节诊断的53.82%、49.80%、54.27%比较,差异无统计学意义(P>0.05)。结论与甲状腺良性结节患者比较,分化型甲状腺癌患者血清TSH水平和阳性率均会显著升高,但Tg水平及阳性率无明显差异。TSH诊断分化型甲状腺癌准确性、敏感性、特异性均高于甲状腺良性结节诊断,可将其作为临床鉴别诊断分化型甲状腺癌的重要检测指标,以提高临床诊断准确性。

Objective To investigate the diagnostic value of thyroglobulin(Tg)and thyroid stimulating hormone(TSH)levels in differentiated thyroid carcinoma.Methods Totally 56 patients with differentiated thyroid cancer who were treated in Rugao Bo'ai Hospital and Rugao People's Hospital from March 2018 to August 2020 were selected as the observation group,and 56 patients with benign thyroid nodules who were diagnosed and treated in the same period were selected as the control group.The serum Tg and TSH levels,positive detection rate,diagnostic accuracy,sensitivity and specificity of different diagnostic indicators were compared between the two groups.Results TSH level and positive rate in the observation group were higher than those in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in Tg level and positive rate between the two groups(P>0.05).The accuracy,sensitivity and specificity of SH in the diagnosis of differentiated thyroid carcinoma were 80.72%,85.58%and 65.84%,respectively,which were higher than 45.27%,26.33%and 46.96%of benign thyroid nodules,and the difference was statistically significant(P<0.05).The accuracy,sensitivity and specificity of Tg in the diagnosis of differentiated thyroid cancer were 54.53%,52.32%and 56.24%,respectively,which was compared with 53.82%,49.80%and 54.27%of benign thyroid nodules,and the difference was not statistically significant(P>0.05).Conclusion Compared with patients with benign thyroid nodules,the serum TSH level and positive rate of patients with differentiated thyroid cancer are significantly increased,but there is no significant difference in Tg level and positive rate.The accuracy,sensitivity and specificity of TSH in the diagnosis of differentiated thyroid cancer are higher than those of benign thyroid nodules,which can be used as an important detection index for clinical differential diagnosis of differentiated thyroid cancer to improve the accuracy of clinical diagnosis.