摘要
目的探讨血清中甲状腺球蛋白(Tg)在分化型甲状腺癌(DTC)患者术后监测和随访中的临床价值。方法收集2015年3月至2018年4月本科室收治的300例DTC患者,经甲状腺全切除术+131I清甲治疗+促甲状腺激素(TSH)抑制,每半年随访,进行血清Tg和TgAb水平检测。根据随访期间是否发生淋巴结转移将患者分成观察组(发生淋巴结转移组)和对照组(未发生淋巴结转移组)。结果随访12~48个月,发生淋巴转移32例,未发生淋巴转移268例。两组患者的平均年龄、性别构成、病理分型、肿瘤直径、初次术后分期及是否为多灶性情况,组间具有可比性(P>0.05)。术后1年观察组Tg水平[10.46 ng/mL(1.68,21.44)]显著高于对照组[0.02 ng/mL(0.01,0.04)],差异有统计学意义(P<0.05)。在发生淋巴结转移的观察组中,Tg和/或TgAb阳性表达者占96.87%,显著高于对照组的1.49%,差异有统计学意义(P<0.05);观察组中单独Tg阳性的表达率为50%,显著高于对照组的0.75%(P<0.05);观察组中单独TgAb阳性的表达率为15.62%,显著高于对照组的0.75%(P<0.05);而观察组中Tg(-)TgAb(-)的百分率小于对照组,差异有统计学意义(P<0.05)。结论Tg在TgAb低表达情况下对于预测甲状腺癌的复发转移有一定的指导意义,两者的合理联合检测能更有效地判断患者的疗效及预后。
Objective To investigate the clinical value of serum thyroglobulin(Tg)in postoperative monitoring and follow-up of patients with differentiated thyroid cancer(DTC).Methods A total of 300 DTC cases admitted to our department from March 2015 to April 2018 were collected.The patients underwent total thyroidectomy+131I treatment+thyroid stimulating hormone(TSH)inhibition,The serum levels of TG and TGAb were tested after half-yearly follow-up.The patients were divided into observation group(lymph node metastasis group)and control group(no lymph node metastasis group)according to whether lymph node metastasis occurred during follow-up.Results During 12 to 48 months of follow-up,32 patients had lymphatic metastasis and 268 had no lymphatic metastasis.The average age,gender composition,pathological classification,tumor diameter,initial postoperative staging,and multifocal condition were comparable between the two groups(P>0.05).The Tg level of observation group[10.46 ng/ml(1.68,21.44)]was significantly higher than that of the control group[0.02 ng/ml(0.01,0.04)]one year after operation,and the difference was statistically significant(P<0.05).In the observation group where lymph node metastasis occurred,96.87% of patients with Tg or TgAb expression were significantly higher than the 1.49%(P<0.05)in the control group,with a statistical difference.The expression rate of Tg positive in the observation group was 50%,which was significantly higher than the 0.75%in the control group(P<0.05);The expression rate of TgAb in the observation group was 15.62%,which was significantly higher than the 0.75% in the control group(P<0.05);The percentage of Tg(-)TgAb(-)in the observation group was smaller than that of the control group(P<0.05),and the difference was statistically significant.Conclusion Tg has a certain guiding significance in predicting the recurrence and metastasis of thyroid cancer under the condition of low expression of TgAb.The reasonable joint test of the two can more effectively judge the patient's efficacy and progn
作者
王瑞娟
肖雪明
林强
黄金珠
郑秀琴
曾焕红
柯奶灼
WANG Ruijuan;XIAO Xueming;LIN Qiang;HUANG Jinzhu;ZHENG Xiuqin;ZENG Huanhong;KE Naizhuo(Department of Basic Surgery,Fujian Provincial Hospital,Clinical Medical Collegeof Fujian Medical University,Fuzhou,Fujian 350001,China)
出处
《福建医药杂志》
CAS
2019年第6期33-36,共4页
Fujian Medical Journal
关键词
分化型甲状腺癌
甲状腺球蛋白
转移
预后
differentiated thyroid cancer
thyroglobulin
metastasis
prognosis
