血清甲状腺球蛋白在分化型甲状腺癌患者术后疗效及预后评价中的应用效果

The Application Effect of Serum Thyroglobulin in Postoperative Efficacy and Prognosis Evaluation of Patients with Differentiated Thyroid Cancer

目的探讨血清甲状腺球蛋白(Tg)在分化型甲状腺癌(DTC)患者术后疗效及预后评价中的应用效果。方法选取2015年6月至2016年5月于医院拟行清甲术治疗的171例DTC患者作为研究对象,根据患者预后分为复发组(9例)和未复发组(162例)。比较两组手术前后患者血清Tg水平,分析血清Tg预测DTC患者术后复发的最佳临界值,并分析血清Tg水平与DTC患者术后生存期的关系。结果术前,两组血清Tg水平比较,差异无统计学意义(P>0.05);术后,复发组血清Tg水平高于未复发组,差异有统计学意义(P<0.05);术后第12个月,DTC患者血清Tg水平对预测无病生存的受试者工作特征(ROC)曲线下面积(AUC)为0.748,最佳截断值为1.70μg/L,约登指数最大(0.53),对应的灵敏度和特异度分别为0.86和0.99(P<0.05)。结论血清Tg可作为DTC患者术后疗效及预后评价的监测指标。

Objective To explore the application effect of serum thyroglobulin(Tg)in postoperative efficacy and prognosis evaluation of patients with differentiated thyroid cancer.Methods With the selection of 171 DTC patients who planned to undergo thyroidectomy in the hospital from June 2015 to May 2016 as the research subjects,they were divided into the recurrence group(9 cases)and the non-recurrence group(162 cases)based on their prognosis.With the detection of the serum Tg levels of patients before and after surgery,the correlation between postoperative recurrence in DTC patients and serum Tg levels was analyzed through multiple regression analysis,and the optimal threshold for postoperative recurrence in DTC patients was predicted by serum Tg levels;Meanwhile,with long-term follow-up for DTC patients,the relationship between serum Tg and survival after treatment of DTC patients was analyzed by using Kaplan-Meier curves.Results Before surgery,there was no statistically significant difference in serum Tg levels between the two groups(P>0.05);After surgery,the serum Tg level in the recurrent group was higher than those in the non recurrent group,and the difference was statistically significant(P<0.05);At 12 months after surgery,the area under the curve(AUC)of serum Tg level for predicting disease-free survival in DTC patients was 0.748,the best cut-off value was 1.70μg/L,and the Youden index was the largest(0.53).The corresponding sensitivity and specificity were 0.86 and 0.99(P<0.05).Conclusion Serum Tg can serve as a monitoring indicator for postoperative efficacy and prognosis evaluation in DTC patie nts.