甲状腺球蛋白抗体(TgAb)在分化型甲状腺癌临床诊疗中应用的研究进展

Research progress on the application of thyroglobulin antibody(TgAb)in the clinical diagnosis of differentiated thyroid carcinoma

甲状腺癌是内分泌系统最为常见的恶性肿瘤,近年来甲状腺癌的患病率持续增长,已成为全世界女性发病率增长最快的恶性肿瘤。分化型甲状腺癌(differentiated thyroid carcinoma,DTC)是甲状腺癌中最常见的类型。甲状腺球蛋白(thyroglobulin,Tg)是监测DTC手术和碘-131(^(131)I)治疗后转移或者复发的血清肿瘤标志物。甲状腺球蛋白抗体(thyroglobulin antibody,TgAb)是甲状腺自身免疫的常规标志物,常见于慢性淋巴细胞性甲状腺炎,也有学者认为TgAb水平升高与甲状腺结节的恶性风险增加密切相关,是DTC的独立危险因素。DTC患者的TgAb阳性干扰了Tg的检测,从而限制了Tg在DTC患者监测中的作用。目前国际上大多数学者认为当血清Tg测定因TgAb出现而受干扰的情况下,TgAb水平可以当做DTC的替补肿瘤标志物。DTC患者术后TgAb水平的变化,不但在DTC转移有一定的预测价值,而且可以评估服用^(131)I后的清甲疗效。此外,DTC术后随访时TgAb水平增高与DTC复发风险有所关联。因此本文对TgAb在DTC中临床应用中的研究进展进行综述,为TgAb阳性患者的临床决策提供更多依据。

Thyroid cancer is the most common malignant tumor in the endocrine system.In recent years,the incidence of thyroid cancer has been increasing continuously,and has become the fastest growing malignant tumor in the world for women.Differentiated thyroid carcinoma(DTC)is the most common types of thyroid cancer.Thyroglobulin(Tg)is a serum tumor marker that monitors metastasis or recurrence after DTC surgery and iodine-131(^(131)I)treatment.Thyroglobulin antibody(TgAb)a conventional thyroid autoimmune marker,is commonly seen in chronic lymphocytic thyroiditis.Some scholars believe that elevated TgAb level is closely related to the increased risk of thyroid nodules,and is an independent risk factor for DTC.Positive TgAb in DTC patients interferes with the detection of Tg,thus limiting the role of Tg in the monitoring of DTC patients.At present,most scholars in the world believe that TgAb level can be used as a substitute tumor marker for DTC when serum Tg measurement is disturbed by the presence of TgAb.Postoperative TgAb level in DTC patients not only has a certain predictive value in DTC metastasis,but also can be evaluated after taking ^(131)I to clear the curative effect.In addition,increased TgAb levels were associated with the risk of DTC recurrence during post-DTC follow-up.Therefore,this paper summarized the research progress of TgAb in the clinical application of DTC to provide more basis for the clinical decision-making of TgAb positive patients.