国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2015年
2期
110-115
,共6页
甲状腺肿瘤%甲状腺结节%甲状腺球蛋白%促甲状腺素%抗甲状腺球蛋白抗体%化学发光测定法%放射免疫测定
甲狀腺腫瘤%甲狀腺結節%甲狀腺毬蛋白%促甲狀腺素%抗甲狀腺毬蛋白抗體%化學髮光測定法%放射免疫測定
갑상선종류%갑상선결절%갑상선구단백%촉갑상선소%항갑상선구단백항체%화학발광측정법%방사면역측정
Thyroid neoplasms%Thyroid nodule%Thyroglobulin%Thyrotropin%Antithyroglobulin antibody%Chemiluminescent measurements%Radioimmunoassay
目的 探讨患者术前血清促甲状腺激素、甲状腺球蛋白(Tg)、抗甲状腺球蛋白抗体(TgAb)浓度在预测甲状腺癌中的价值.方法 对122例接受手术治疗的甲状腺结节患者进行术前研究,以术后病理结果作为甲状腺结节性质的诊断金标准进行对照,其中分化型甲状腺癌55例,良性结节67例.采用化学发光法测定Tg和TSH;放射免疫分析法测定TgAb;采用彩色多普勒超声诊断仪检查甲状腺组织和颈部淋巴结.结果 甲状腺癌组的术前血清Tg水平(24.09±64.59) ng/ml和甲状腺良性结节组(23.37±112.14)ng/ml间的差异无统计学意义(Z=-1.092,P＞0.05);甲状腺癌组的TSH水平(2.32±2.28)mIU/L高于甲状腺良性结节组(1.75±1.22)mIU/L,(Z=-2.107,P＜0.05);甲状腺癌组Tg联合TgAb的阳性率(72.7％)高于甲状腺良性结节组(55.2％)(x2=3.975,P＜0.05).各指标预测甲状腺癌的受试者工作特征曲线示,TSH值的曲线下面积(AUC)为0.611[95％可信区间(95％CI):0.509～0.713],P＜0.05,最佳临界值2.31 mIU/L,灵敏度和特异度分别为71.6％和50.9％;TSH∶Tg值的AUC为0.617(95％CI:0.518～0.716),P＜0.05,最佳临界TSH∶Tg值为0.11 IU/mg,灵敏度和特异度分别为61.2％和50.9％;Tg曲线AUC＜0.5.结论 术前血清Tg的异常升高不是甲状腺癌的独立预测因素,但其结合TgAb阳性、TSH∶Tg值＞0.11 IU/mg可作为甲状腺癌的危险预测因素,可能是甲状腺超声检查的一种有效补充诊断手段.
目的 探討患者術前血清促甲狀腺激素、甲狀腺毬蛋白(Tg)、抗甲狀腺毬蛋白抗體(TgAb)濃度在預測甲狀腺癌中的價值.方法 對122例接受手術治療的甲狀腺結節患者進行術前研究,以術後病理結果作為甲狀腺結節性質的診斷金標準進行對照,其中分化型甲狀腺癌55例,良性結節67例.採用化學髮光法測定Tg和TSH;放射免疫分析法測定TgAb;採用綵色多普勒超聲診斷儀檢查甲狀腺組織和頸部淋巴結.結果 甲狀腺癌組的術前血清Tg水平(24.09±64.59) ng/ml和甲狀腺良性結節組(23.37±112.14)ng/ml間的差異無統計學意義(Z=-1.092,P＞0.05);甲狀腺癌組的TSH水平(2.32±2.28)mIU/L高于甲狀腺良性結節組(1.75±1.22)mIU/L,(Z=-2.107,P＜0.05);甲狀腺癌組Tg聯閤TgAb的暘性率(72.7％)高于甲狀腺良性結節組(55.2％)(x2=3.975,P＜0.05).各指標預測甲狀腺癌的受試者工作特徵麯線示,TSH值的麯線下麵積(AUC)為0.611[95％可信區間(95％CI):0.509～0.713],P＜0.05,最佳臨界值2.31 mIU/L,靈敏度和特異度分彆為71.6％和50.9％;TSH∶Tg值的AUC為0.617(95％CI:0.518～0.716),P＜0.05,最佳臨界TSH∶Tg值為0.11 IU/mg,靈敏度和特異度分彆為61.2％和50.9％;Tg麯線AUC＜0.5.結論 術前血清Tg的異常升高不是甲狀腺癌的獨立預測因素,但其結閤TgAb暘性、TSH∶Tg值＞0.11 IU/mg可作為甲狀腺癌的危險預測因素,可能是甲狀腺超聲檢查的一種有效補充診斷手段.
목적 탐토환자술전혈청촉갑상선격소、갑상선구단백(Tg)、항갑상선구단백항체(TgAb)농도재예측갑상선암중적개치.방법 대122례접수수술치료적갑상선결절환자진행술전연구,이술후병리결과작위갑상선결절성질적진단금표준진행대조,기중분화형갑상선암55례,량성결절67례.채용화학발광법측정Tg화TSH;방사면역분석법측정TgAb;채용채색다보륵초성진단의검사갑상선조직화경부림파결.결과 갑상선암조적술전혈청Tg수평(24.09±64.59) ng/ml화갑상선량성결절조(23.37±112.14)ng/ml간적차이무통계학의의(Z=-1.092,P＞0.05);갑상선암조적TSH수평(2.32±2.28)mIU/L고우갑상선량성결절조(1.75±1.22)mIU/L,(Z=-2.107,P＜0.05);갑상선암조Tg연합TgAb적양성솔(72.7％)고우갑상선량성결절조(55.2％)(x2=3.975,P＜0.05).각지표예측갑상선암적수시자공작특정곡선시,TSH치적곡선하면적(AUC)위0.611[95％가신구간(95％CI):0.509～0.713],P＜0.05,최가림계치2.31 mIU/L,령민도화특이도분별위71.6％화50.9％;TSH∶Tg치적AUC위0.617(95％CI:0.518～0.716),P＜0.05,최가림계TSH∶Tg치위0.11 IU/mg,령민도화특이도분별위61.2％화50.9％;Tg곡선AUC＜0.5.결론 술전혈청Tg적이상승고불시갑상선암적독립예측인소,단기결합TgAb양성、TSH∶Tg치＞0.11 IU/mg가작위갑상선암적위험예측인소,가능시갑상선초성검사적일충유효보충진단수단.
Objective To explore the values of preoperative serum thyroid stimulating hormone,thyroglobulin and antithyroglobulin antibody in predicting the risk of differentiated thyroid carcinoma.Methods 122 patients with thyroid nodules who got operations were studied,among which 55 patients with differentiated thyroid carcinoma(54 papillary and 1 follicular),67 cases with benign thyroid nodules (40 nodular goiter and 27 adenoma).Serum thyroid-stimulating hormone (TSH) and thyroglobulin (Tg) were measured by chemiluminescence method,and antithyroglobulin antibody (TgAb) by radioimmunoassay.Thyroid tissues and cervical lymph nodes were checked using color doppler ultrasonic diagnostic instrument and the postoperative pathological results was regard as the gold standard of diagnosing thyroid cancer.Results Preoperative serum Tg levels in thyroid cancer group (24.09±64.59)ng/ml and benign thyroid nodules group (23.37 ± 112.14) ng/ml had no statistical differences (Z=1.092,P＞0.05).TSH levels in thyroid carcinoma group (2.32±2.28) mIU/L were higher than that in benign thyroid nodules group (1.75 ±1.22) mIU/L (Z=2.107,P＜0.05).The positive rate of Tg combined with TgAb in thyroid cancer group (72.7％) was higher than that in benign thyroid nodules group (55.2％) (x2=3.975,P＜0.05).Receiver operating characteristic (ROC) curves showing sensitivity as a function of specificity were calculated for TSH,Tg levels and TSH ∶ Tg values to evaluate the potential accuracy of the three index as predicting differentiated thyroid carcinoma.The area under the curve (AUC) of TSH was 0.611 [95％ confidence interval (95％ CI):0.509～0.713],P＜0.05.The optimum threshold in ROC curves of TSH was 2.31 mIU/L.The sensitivity and specificity of TSH were 71.6％ and 50.9％ respectively.The AUC of TSH ∶ Tg values was 0.617 (95％ CI:0.518～0.716),P＜0.05.The best critical value of TSH ∶ Tg was 0.11 IU/mg.The sensitivity and specificity of TSH ∶ Tg were 61.2％ and 50.9％ respectively.The AUC of Tg was less than 0.5.Conclusions Serum thyroglobulin elevated abnormally is not an independent predicting factor of differentiated thyroid cancer.The elevated Tg levels and/or positive TgAb and TSH ∶ Tg＞0.11 IU/mg can be used as effective supplementary means of ultrasound examination in predicting differentiated thyroid carcinoma.
