抗甲状腺球蛋白抗体在甲状腺癌合并结节性甲状腺肿患者中对复发或转移的诊断价值

The Diagnostic Value of Serum Anti-Thyroglobulin Antibody for Metastasis of Differentiated Thyroid Carcinoma Complicated with Nodular Goiter

目的分析247例分化型甲状腺癌(differentiated thyroid carcinoma,DTC)合并结节性甲状腺肿(nodular Goiter,NG)患者经全切或次全切术后我科接受131 I治疗前血清抗甲状腺球蛋白抗体(antithyroglobulin antibody,TgAb)的水平对甲状腺癌复发或转移的诊断价值,并确定其相应的截断值。方法DTC合并NG患者根据TgAb水平分为TgAb阳性和阴性两组,并比较两组患者的临床病理特征。经随访所有患者分为有或无复发/转移两组,进行受试者特征工作曲线(receiver operating characteristic,ROC)分析,计算DTC合并NG患者消融前TgAb预测复发或转移的截断值。结果研究数据显示,TgAb阳性患者的TNM分期I级高于TgAb阴性组患者,且差异具有统计学意义。在DTC合并NG患者中,以ROC分析计算出TgAb预测复发或转移的截断值为152.3kIU/L(灵敏度65.4%,特异性78.4%)。TgAb的曲线下面积(AUC)为0.757。结论在DTC合并NG患者中,以ROC曲线得出的TgAb预测复发或转移的截断值为152.3kIU/L。

Objective To analyze the diagnostic value of preablation stimulated serum anti-thyroglobulin antibody(TgAb)levels for a total of 247 patients with differentiated thyroid carcinoma(DTC)complicated with nodular goiter(NG)underwent the I-131 treatment after the operation and to determine corresponding cutoff values.Methods The studied patients were divided into the TgAb-positive and TgAb-negative group.Demographic characteristics and long-term outcomes(follow-up range:9-30 months)were compared between groups.Receiver operating characteristic(ROC)curve analysis was conducted to analyze cutoff values of TgAb for predicting the metastasis for patients with DTC complicated with NG.Results TNM stage I of TgAb-positive patients was superior to the TgAb-negative group(P=0.027).In patients with DTC complicated with NG,the cut off values of TgAb for predicting the metastasis was 152.3kIU/L(with sensitivity of 65.4%and specificity of 78.4%)according to ROC analysis.AUCs of Tg and TgAb was 0.757.Conclusion For patients with DTC complicated with NG,the cutoff value of TgAb for predicting the metastasis is 152.3kIU/L according to ROC curves.