中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2014年
4期
292-296
,共5页
分化型甲状腺癌%桥本甲状腺炎%甲状腺球蛋白%抗甲状腺球蛋白抗体
分化型甲狀腺癌%橋本甲狀腺炎%甲狀腺毬蛋白%抗甲狀腺毬蛋白抗體
분화형갑상선암%교본갑상선염%갑상선구단백%항갑상선구단백항체
Thyroid carcinoma%Hashimoto's thyroiditis%Thyroglobulin%Antithyroglobulin antibody
目的 研究分析分化型甲状腺癌(differentiated thyroid carcinoma)合并桥本甲状腺炎患者手术及131碘治疗后,血清甲状腺球蛋白(thyroglobulin,Tg)与抗甲状腺球蛋白抗体(antithyroglobulin antibody,TgAb)水平对甲状腺癌转移的诊断价值,并确定其相应的危险度.方法 共154例分化型甲状腺癌合并桥本甲状腺炎患者,所有患者术后均接受131碘治疗,并进行3年随访.154例患者分为有或无复发/转移组,根据不同Tg水平分为3个亚组分别为:Tg≤1 μg/L组,1μg/L＜Tg≤10 μg/L组和10 μg/L＜Tg≤100 μg/L,以TgAb＞40 kIU/L被认为TgAb阳性,进行相对危险度分层分析,研究各不同Tg水平组别中,TgAb阳性对转移的预测价值.结果 当Tg≤1 μg/L时,TgAb＞40 kIU/L对复发或转移的诊断价值最大,转移相对危险度是27.000(95％ CI6.727 ～ 108.374),TgAb阳性与转移高度相关.而当Tg＞1 μg/L时,应以Tg水平为准.此外,TgAb的水平与甲状腺癌的病理类型关系不大.结论 在Tg≤1 μg/L患者中,TgAb＞40 kIU/L是预测甲状腺癌复发或转移的最佳值.
目的 研究分析分化型甲狀腺癌(differentiated thyroid carcinoma)閤併橋本甲狀腺炎患者手術及131碘治療後,血清甲狀腺毬蛋白(thyroglobulin,Tg)與抗甲狀腺毬蛋白抗體(antithyroglobulin antibody,TgAb)水平對甲狀腺癌轉移的診斷價值,併確定其相應的危險度.方法 共154例分化型甲狀腺癌閤併橋本甲狀腺炎患者,所有患者術後均接受131碘治療,併進行3年隨訪.154例患者分為有或無複髮/轉移組,根據不同Tg水平分為3箇亞組分彆為:Tg≤1 μg/L組,1μg/L＜Tg≤10 μg/L組和10 μg/L＜Tg≤100 μg/L,以TgAb＞40 kIU/L被認為TgAb暘性,進行相對危險度分層分析,研究各不同Tg水平組彆中,TgAb暘性對轉移的預測價值.結果 噹Tg≤1 μg/L時,TgAb＞40 kIU/L對複髮或轉移的診斷價值最大,轉移相對危險度是27.000(95％ CI6.727 ～ 108.374),TgAb暘性與轉移高度相關.而噹Tg＞1 μg/L時,應以Tg水平為準.此外,TgAb的水平與甲狀腺癌的病理類型關繫不大.結論 在Tg≤1 μg/L患者中,TgAb＞40 kIU/L是預測甲狀腺癌複髮或轉移的最佳值.
목적 연구분석분화형갑상선암(differentiated thyroid carcinoma)합병교본갑상선염환자수술급131전치료후,혈청갑상선구단백(thyroglobulin,Tg)여항갑상선구단백항체(antithyroglobulin antibody,TgAb)수평대갑상선암전이적진단개치,병학정기상응적위험도.방법 공154례분화형갑상선암합병교본갑상선염환자,소유환자술후균접수131전치료,병진행3년수방.154례환자분위유혹무복발/전이조,근거불동Tg수평분위3개아조분별위:Tg≤1 μg/L조,1μg/L＜Tg≤10 μg/L조화10 μg/L＜Tg≤100 μg/L,이TgAb＞40 kIU/L피인위TgAb양성,진행상대위험도분층분석,연구각불동Tg수평조별중,TgAb양성대전이적예측개치.결과 당Tg≤1 μg/L시,TgAb＞40 kIU/L대복발혹전이적진단개치최대,전이상대위험도시27.000(95％ CI6.727 ～ 108.374),TgAb양성여전이고도상관.이당Tg＞1 μg/L시,응이Tg수평위준.차외,TgAb적수평여갑상선암적병리류형관계불대.결론 재Tg≤1 μg/L환자중,TgAb＞40 kIU/L시예측갑상선암복발혹전이적최가치.
Objective To investigate the value of serum thyroglobulin (Tg) and antithyroglobulin antibody (TgAb) in differentiated thyroid carcinoma complicated with Hashimoto's thyroiditis after thyroid ablation.Methods Serum Tg and TgAb levels and the status of illness in 154 differentiated thyroid carcinoma patients with coexistent Hashimoto's thyroiditis and confirmed pathology after surgery followed by remnant ablation were performed during three years follow up.Tg and TgAb levels were assessed by chemiluminescent immunoassay assay.The cases were divided into three groups (according to the level of Tg):Tg ≤ 1 μg/L group,1 μg/L＜Tg ≤ 10 μg/L group and 10 μg/L＜Tg≤ 100 μg/L group.TgAb＞40 kIU/L was considered as positive,Cox's proportional hazard model was used to analyse prognostic value in different levels of Tg and TgAb for disease-free survival and recurrence.Results Compared with 1 μg/L＜Tg≤ 10 μg/L group and 10 μg/L＜Tg≤ 100 μg/L group,the relative risk in reflecting cancer recurrence (TgAb＞40 kIU/L) in Tg ≤ 1 μg/L group was 27.000 (95 ％ CI 6.727-108.374).The value of TgAb＞40 kIU/L in Tg≤ 1 μg/L group was greatly increased and highly correlated with metastasis.However,In the condition of Tg＞ 1 μg/L,the disease will be based on the level of TgAb.Conclusion The value of TgAb＞40 kIU/L in Tg ≤ 1 μg/L group seems to be the optimal cutoff value correlated with recurrence and metastasis of differentiated thyroid carcinoma.
