CAJ | 학술논문

目的探讨刺激性Tg在乳头状甲状腺癌(PTC)术后、131I治疗前对远处转移的预测价值.方法 231例经过甲状腺全切术拟行131I治疗的PTC患者,根据是否存在远处转移分为M1[38例,男15例,女23例,平均年龄(43.9±16.3)岁]和M0[193例,男60例,女133例,平均年龄(42.4±11.4)岁]2组.用t检验及x2检验观察2组的年龄、性别差异是否有统计学意义,用Mann-Whitney 秩和检验比较2组间Tg水平,通过ROC曲线及最佳诊断界值点(DCP)评估刺激性Tg对远处转移的预测价值.结果 2组的年龄(t=-0.675,P=0.50)、性别(x2=1.02,P=0.31)差异均无统计学意义.2组刺激性Tg水平分别为1.5～17.5 μg/L和93.8～1000.0 μg/L,两者差异有统计学意义(U=787.5,P ＜0.001).Tg的ROC AUC为0.893(95％ CI:0.823～0.962),Tg界值点为52.75 μg/L,对应的灵敏度、特异性分别为78.90％和91.70％.结论刺激性Tg在PTC全切术后、131I治疗前对PTC的远处转移有重要的预测价值.
목적 탐토자격성Tg재유두상갑상선암(PTC)술후、131I치료전대원처전이적예측개치.방법 231례경과갑상선전절술의행131I치료적PTC환자,근거시부존재원처전이분위M1[38례,남15례,녀23례,평균년령(43.9±16.3)세]화M0[193례,남60례,녀133례,평균년령(42.4±11.4)세]2조.용t검험급x2검험관찰2조적년령、성별차이시부유통계학의의,용Mann-Whitney 질화검험비교2조간Tg수평,통과ROC곡선급최가진단계치점(DCP)평고자격성Tg대원처전이적예측개치.결과 2조적년령(t=-0.675,P=0.50)、성별(x2=1.02,P=0.31)차이균무통계학의의.2조자격성Tg수평분별위1.5～17.5 μg/L화93.8～1000.0 μg/L,량자차이유통계학의의(U=787.5,P ＜0.001).Tg적ROC AUC위0.893(95％ CI:0.823～0.962),Tg계치점위52.75 μg/L,대응적령민도、특이성분별위78.90％화91.70％.결론 자격성Tg재PTC전절술후、131I치료전대PTC적원처전이유중요적예측개치.
Objective To investigate the value of pre-ablation stimulated Tg in predicting distant metastasis of papillary thyroid cancer (PTC).Methods The study included 231 patients with PTC who had undergone total thyroidectomy and subsequent 131I therapy.Patients were divided into two groups as M1(38 cases,15 males,23 females,average age (43.9 ± 16.3) y) and M0(193 cases,60 males,133 females,average age (42.4 ± 11.4) y) according to the presence and absence of distant metastases,respectively.T-test and x2 test were used to evaluate the statistical differences between the two groups.The Tg value between M0 and M1 was compared by Mann-Whitney rank-sum test.The ROC curves and diagnostic critical point (DCP) were analyzed to evaluate the predictive value of stimulated Tg.Results There was no significant difference between the two groups in age (t=-0.675,P=0.50) and gender (x2=1.02,P=0.31).Pre-ablation stimulated Tg was significantly different between the two groups (the Mann-Whitney rank-sum test:U=787.5,P＜0.001).Area under the ROC curve for Tg levels was 0.893 (95％ CI:0.863-0.962).The cut-off value of DCP of Tg was 52.75 μg/L with a sensitivity of 78.90％ and specificity of 91.70％.Conclusion Stimulated Tg may be a useful "diagnostic tumor marker" for predicting distant metastases of PTC before the first 131I ablation therapy.