甲状腺细针穿刺对甲状腺相关指标的影响

The Effect of Thyroid Fine-needle Aspiration on Thyroid-relevant Indexes

[目的]探讨甲状腺细针穿刺(fine-needle aspiration,FNA)对甲状腺相关指标的影响。[方法]使用SPSS 26.0软件进行非参数检验比较甲状腺FNA前后相关指标的变化。[结果]共纳入448例患者,男性患者甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)在穿刺后第1周增长0.63 IU/mL(P=0.013),促甲状腺素(thyroid stimulating hormone,TSH)在第5周下降27.6%(P=0.043),BRAF V600E突变组甲状腺球蛋白(thyroglobulin,Tg)在第2周升高33%(P=0.023)。具有该突变的女性Tg在第1周内升高7.1%(P=0.029),甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)在穿刺后第2周内升高、第3周内降低(P<0.05),TgAb、TPOAb在5周后仍较穿刺前升高(P<0.05),无该突变的女性甲状腺相关指标不受FNA影响(P>0.05)。[结论]男性患者的甲状腺相关指标在行甲状腺FNA的5周后恢复至穿刺前水平。BRAF V600E突变女性患者5周后TgAb、TPOAb仍较前升高。建议甲状腺FNA 5周后行甲状腺相关指标的血清学检验,若仍有显著变化可能与BRAF V600E突变有关。

[Objective]To explore the effect of thyroid fine-needle aspiration(FNA)on thyroid-relevant indexes.[Methods]This retrospective study compared thyroid-relevant indexes before and after fineneedle aspiration by SPSS 26.0.[Results]There were 448 qualified patients.In male patients,thyroid peroxidase antibody(TPOAb)increased to 0.63 IU/mL in the first week after FNA(P=0.013),thyroid stimulating hormone(TSH)dropped by 27.6%in the 5th week(P=0.043),the group of BRAF V600E mutation had a growth of 33%in thyroglobulin(Tg)(P=0.023).In female patients with this mutation,Tg increased by 7.1%in the 1st week after FNA(P=0.029),thyroglobulin antibody(TgAb)rose in the 2nd week and fell in the 3rd week after FNA,the level of TgAb and TPOAb were still higher than the baseline 5 weeks after FNA(P<0.05).FNA didn’t significantly affect the thyroid-relevant indexes in female without the mutation(P>0.05).[Conclusion]The thyroid-relevant indexes in male recovered from thyroid FNA within 5 weeks.The level of TgAb and TPOAb in female with BRAF V600E mutation were still higher than those before FNA even after 5 weeks.The serum indexes of thyroid are recommended to be tested 5 weeks after FNA,while some of them may still change significantly because of BRAF V600E mutation.