血清Tg-Ab、TSH及TPO-Ab联合检测对甲状腺结节良恶性的鉴别诊断价值研究

Study on the differential diagnostic value of serum Tg-Ab,TSH and TPO-Ab detection for benign and malignant thyroid nodules

目的分析抗甲状腺球蛋白抗体(Tg-Ab)、促甲状腺激素(TSH)、抗甲状腺过氧化物酶抗体(TPO-Ab)联合检测对甲状腺结节良恶性的鉴别诊断价值。方法选取67例甲状腺结节患者,按病理结果划分为良性组共46例及恶性组共21例。检测并对比两组血清Tg-Ab、TSH、TPO-Ab水平;描绘受试者工作特征曲线(ROC),分析三项指标诊断甲状腺结节良恶性的价值。结果恶性组的Tg-Ab为(129.81±9.63)IU/ml、TSH为(5.89±1.41)mIU/L、TPO-Ab为(37.46±3.58)IU/ml,高于良性组的(65.40±5.37)IU/ml、(1.71±0.53)mIU/L、(21.57±2.39)IU/ml(P<0.05)。ROC结果显示:Tg-Ab、TSH、TPO-Ab联合检测甲状腺结节良恶性的曲线下面积(AUC)为0.913[95%CI=(0.840,0.985)],大于Tg-Ab单独检测的0.798[95%CI=(0.693,0.902)]、TSH单独检测的0.806[95%CI=(0.701,0.910)]、TPO-Ab单独检测的0.874[95%CI=(0.793,0.955)]。结论Tg-Ab、TSH、TPO-Ab联合检测可有效鉴别诊断出甲状腺结节的良恶性,有一定的诊断效能,值得临床推广应用。

Objective To analyze the differential diagnostic value of serum thyroglobulin antibody(Tg-Ab),thyroid-stimulating hormone(TSH)and thyroid peroxidase antibody(TPO-Ab)detection for benign and malignant thyroid nodules.Methods 67 patients with thyroid nodules were selected as the subjects.All cases were divided into 46 cases of benign group and 21 cases of malignant group by pathological results.Serum levels of Tg-Ab,TSH and TPO-Ab were detected and compared between the two groups.The receiver operating characteristic(ROC)curve was drawn,and the diagnostic value of three indicators for benign and malignant thyroid nodules was analyzed.Results The Tg-Ab of the malignant group was(129.81±9.63)IU/ml,TSH was(5.89±1.41)mIU/L and TPO-Ab was(37.46±3.58)IU/ml,which were higher than(65.40±5.37)IU/ml,(1.71±0.53)mIU/L and(21.57±2.39)IU/ml in the benign group(P<0.05).The ROC results showed that the area under the curve(AUC)of Tg-Ab,TSH,and TPO-Ab in combination for benign and malignant thyroid nodules was 0.913[95%CI=(0.840,0.985)],which was greater than 0.798[95%CI=(0.693,0.902)]by Tg-Ab alone,0.806[95%CI=(0.701,0.910)]by TSH alone,and 0.874[95%CI=(0.793,0.955)]by TPO-Ab alone.Conclusion The combined detection of Tg-Ab,TSH and TPO-Ab can effectively differentiate the benign and malignant thyroid nodules,which has certain diagnostic efficacy and is worthy of clinical application.