甲状腺球蛋白与抗甲状腺球蛋白抗体在甲状腺癌合并桥本病中对癌转移的诊断价值

doi:10.3969/j.issn.1674-8115.2014.08.017

上海交通大学学报（医学版）

甲状腺球蛋白与抗甲状腺球蛋白抗体在甲状腺癌合并桥本病中对癌转移的诊断价值

柴红，陈泽泉，余永利

上海交通大学附属第六人民医院核医学科，上海 200233

出版日期:2014-08-28 发布日期:2014-09-02
通讯作者: 余永利, 电子信箱: yuyonglilili@126.com。
作者简介:柴红（1984—），女，住院医师，硕士; 电子信箱: chaihongggg@126.com。

Diagnostic value of serum thyroglobulin and antithyroglobulin antibody for metastasis of thyroid carcinoma complicated with Hashimoto's thyroiditis

CHAI Hong, CHEN Ze-quan, YU Yong-li

Department of Nuclear Medicine, the Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai 200233, China

Online:2014-08-28 Published:2014-09-02

摘要/Abstract

摘要：

目的研究分析分化型甲状腺癌（DTC）合并桥本病患者手术及¹³¹I治疗后血清甲状腺球蛋白（Tg）与抗甲状腺球蛋白抗体（TgAb）的水平对甲状腺癌转移的诊断价值，并确定其相应的截断值。方法 164例DTC合并桥本病患者术后均接受¹³¹I治疗并进行3年随访。164例患者分为有或无复发／转移两组，进行受试者特征工作曲线（ROC）分析，分析在DTC合并桥本病患者中Tg和TgAb预测转移的截断值。结果以ROC测试的Tg和TgAb预测转移的截断值分别为1.48 μg/L(敏感性72.13%；特异性98.06%) 和45 kIU/L（敏感性48.53%；特异性100%)。Tg和TgAb的曲线下面积（AUC）分别为0.907和0.650。所有甲状腺癌合并桥本病患者，根据转移组Tg与TgAb的测值制作散点图，呈现为直角双曲线形状。结论在DTC合并桥本病患者中，以ROC曲线得出的Tg和TgAb预测转移的截断值分别为1.48 μg/L和45 kIU/L。根据敏感性、特异性和AUC的大小，Tg对甲状腺癌转移的诊断价值高于TgAb。此外，Tg与TgAb在散点图中的测值呈明显的负相关。

关键词: 甲状腺癌, 桥本病, 甲状腺球蛋白, 抗甲状腺球蛋白抗体

Abstract:

Objective To analyze the diagnostic value of serum thyroglobulin (Tg) and antithyroglobulin antibody (TgAb) levels for patients with differentiated thyroid carcinoma (DTC) complicated with Hashimoto's thyroiditis (HT) after the operation and ¹³¹I treatment and to determine corresponding cutoff values. Methods A total of 164 patients with DTC complicated with HT underwent the ¹³¹I treatment after the operation and were followed up for three years. Patients were divided into the recurrence/metastasis group and non-recurrence/metastasis group. The receiver operating characteristic (ROC) curve analysis was conducted to analyze cutoff values of Tg and TgAb for predicting the metastasis for patients with DTC complicated with HT. Results The cutoff values of Tg and TgAb for predicting the metastasis were 1.48 μg/L (with sensitivity of 72.13% and specificity of 98.06%) and 45 kIU/L (with sensitivity of 48.53% and specificity of 100%) according to the ROC analysis. The AUCs of Tg and TgAb were 0.907 and 0.650, respectively. The scatter diagram plotted by measurements of Tg and TgAb of the recurrence/metastasis group was rectangular hyperbola for all patients with DTC complicated with HT. Conclusion For patients with DTC complicated with HT, the cutoff values of Tg and TgAb for predicting the metastasis were 1.48 μg/L and 45 kIU/L according to the ROC curves. Based on the sensitivity, specificity, and AUC, the diagnostic value of Tg was higher than that of TgAb for predicting the metastasis of thyroid carcinoma. Besides, Tg measurements were significantly and negatively correlated to TgAb measurements in the scatter diagram.

Key words: thyroid carcinoma, Hashimoto thyroiditis, thyroglobulin, antithyroglobulin antibody

柴红，陈泽泉，余永利. 甲状腺球蛋白与抗甲状腺球蛋白抗体在甲状腺癌合并桥本病中对癌转移的诊断价值[J]. 上海交通大学学报（医学版）, doi: 10.3969/j.issn.1674-8115.2014.08.017.

CHAI Hong, CHEN Ze-quan, YU Yong-li. Diagnostic value of serum thyroglobulin and antithyroglobulin antibody for metastasis of thyroid carcinoma complicated with Hashimoto's thyroiditis[J]. , doi: 10.3969/j.issn.1674-8115.2014.08.017.

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甲状腺球蛋白与抗甲状腺球蛋白抗体在甲状腺癌合并桥本病中对癌转移的诊断价值

Diagnostic value of serum thyroglobulin and antithyroglobulin antibody for metastasis of thyroid carcinoma complicated with Hashimoto's thyroiditis

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