CAJ | 학술논문

目的确立细针穿刺抽吸物洗脱液甲状腺球蛋白(FNA-Tg)浓度的测定诊断甲状腺乳头状癌颈部淋巴结转移的标准值.方法选择2010年8月至2012年6月期间63例甲状腺癌或术后随访中有淋巴结肿大者行超声引导下细针穿刺抽吸79枚可疑淋巴结,通过电化学发光免疫分析法(ECLIA)测定FNA-Tg和血清甲状腺球蛋白含量(serumTg),分别选择FNA-Tg＞ serumTg、mean +2SD(淋巴结无转移的FNA-Tg平均值加上2倍标准差)、10 ng/ml、ROC曲线最佳工作点(optimal operating point,OOP)及1000 ng/ml做为标准值,对比分析其敏感性、特异性及ROC曲线下面积.结果 5个阳性标准值的敏感性分别为90.70％、90.70％、95.35％、90.70％及65.12％,其中当标准值为1000 ng/ml时,敏感性较低(P＜0.05).5组标准值的特异性分别为97.22％、91.67％、72.22％、97.22％及100％,当标准值为10 ng/ml时,特异性较低(P＜0.05),5个阳性标准值的ROC曲线下面积分别为0.940、0.912、0.838、0.940及0.826,差异无统计学意义(P＞0.05).结论 FNA-Tg/serumTg＞1可做为FNA-Tg阳性标准值,辅助诊断甲状腺乳头状癌颈部淋巴结转移.
목적 학립세침천자추흡물세탈액갑상선구단백(FNA-Tg)농도적측정진단갑상선유두상암경부림파결전이적표준치.방법 선택2010년8월지2012년6월기간63례갑상선암혹술후수방중유림파결종대자행초성인도하세침천자추흡79매가의림파결,통과전화학발광면역분석법(ECLIA)측정FNA-Tg화혈청갑상선구단백함량(serumTg),분별선택FNA-Tg＞ serumTg、mean +2SD(림파결무전이적FNA-Tg평균치가상2배표준차)、10 ng/ml、ROC곡선최가공작점(optimal operating point,OOP)급1000 ng/ml주위표준치,대비분석기민감성、특이성급ROC곡선하면적.결과 5개양성표준치적민감성분별위90.70％、90.70％、95.35％、90.70％급65.12％,기중당표준치위1000 ng/ml시,민감성교저(P＜0.05).5조표준치적특이성분별위97.22％、91.67％、72.22％、97.22％급100％,당표준치위10 ng/ml시,특이성교저(P＜0.05),5개양성표준치적ROC곡선하면적분별위0.940、0.912、0.838、0.940급0.826,차이무통계학의의(P＞0.05).결론 FNA-Tg/serumTg＞1가주위FNA-Tg양성표준치,보조진단갑상선유두상암경부림파결전이.
Objective To investigate the diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy(FNA-Tg).Methods This study included 63 patients with thyroid cancer or with enlarged lymph nodes during the follow-up from Aug.2010 to Jun.2012.Ultrasound-guided fine-needle aspiration was done in the 63 patients with 79 suspicious enlarged lymph nodes.Then thyroglobulin(Tg) in FNA washout fluid and serum Tg were assayed with electrochemiluminescenceimmunoassay(ECLIA).Diagnostic sensitivity,specificity and area under the ROC curve were evaluated according to 5 predetermined threshold levels:FNA-Tg/serum-Tg ＞ 1,mean + 2SD of node-negative patients,10 ng/ml,optimal operating point of ROC curve and 1000 ng/ml.Results The sensitivity value was 90.70％,90.70％,95.35％,90.70％ and 65.12％ respectively on the 5 threshold level,significantly lower than those on the threshold level of 1000 ng/ml(P ＜0.05).The specificity value was 97.22％,91.67％,72.22％,97.22％ and 100％ (P ＞0.05) on those threshold levels,significantly lower than those on the threshold level of 10 ng/ml (P ＜0.05).The area under the ROC curve was 0.940,0.912,0.838,0.940 and 0.826 respectively.There was no statistical difference(P ＞0.05).Conclusion Selecting FNA-Tg/serum-Tg ＞ 1 as a positive threshold value can be a secondary diagnosis of lymph nodes metastasis in patients with papillary thyroid cancer.