摘要
目的评估甲状腺乳头状癌(PTC)术后首次131Ⅰ治疗前刺激性甲状腺球蛋白(ps-Tg)<10μg/L的患者131Ⅰ治疗后的临床转归并探讨ps-Tg水平与临床转归的关系。方法筛选98例ps-Tg<10μg/L PTC术后患者,根据131Ⅰ初始治疗后疗效分为3组,即满意(ER)、不确切(IDR)、欠佳(IR)[血清学欠佳(BIR)及影像学欠佳(SIR)]。比较3组患者的临床病理特征及ps-Tg水平,将这3组患者进一步分为ER和非ER组,比较2组患者的ps-Tg水平,最后通过分析受试者工作特征(ROC)曲线获得ps-Tg诊断界值点,探讨ps-Tg对131Ⅰ治疗后ER的预测价值。结果 3组患者在年龄、性别、颈部超声、复发危险分层、病灶数目、颈部淋巴结转移及病灶大小方面差异无统计学意义(均P>0.05);而在ps-Tg水平方面,3组总体差异有统计学意义(P<0.001)。组间两两比较,ER与IDR(调整后P=0.001)、IR(调整后P=0.015)差异均有统计学意义,IDR与IR(调整后P=0.869)差异不明显;ER组与非ER组ps-Tg水平差异也有统计学意义(P<0.001);ps-Tg与ER关系的ROC曲线下面积为0.777,最佳诊断界值为1.95μg/L,对应灵敏度、特异度均较高,分别为80.00%、70.00%。结论对于ps-Tg <10μg/L的PTC术后患者,ps-Tg≤1.95μg/L可作为提示其临床疗效满意的界值点。
Objective To evaluate the clinical outcome of 131Ⅰ therapy in papillary thyroid Cancer(PTC) with preablative stimulated thyroglobulin(ps-Tg)below 10 μg/L and explore correlation between ps-Tg level and the clinical outcome. Methods Ninety eight PTC patients with ps-Tg below 10 μg/L were selected and divided into four groups [excellent response(ER),indeterminate response(IDR),biochemical incomplete response(BIR) and structural incomplete response(SIR)] according to the response to initial 131Ⅰ therapy. BIR and SIR were classified as incomplete response(IR).The clinicopathological features and ps-Tg level were compared among the three groups. Three groups of patients were further divided into ER and non-ER groups and the ps-Tg level was compared between them. Lastly,the optimal cut-off point was obtained by analyzing ROC curve to explore the value of ps-Tg for predicting excellent response(ER). Results There was no significant difference in age,sex,neck ultrasound,recurrence risk,number of lesions,cervical lymph node metastasis and tumor size among the three groups(all P> 0.05),but there was significant difference in ps-Tg level among them(P<0.001). Two comparisons further made between groups in ps-Tg level,and there was significant difference between ER and IDR(adjusted P=0.001),IR(adjusted P=0.015),but there was no significant difference between IDR and IR(adjusted P=0.869). There was also significant difference in ps-Tg level between ER and non-ER(P<0.001). Area under the ROC curve was 0.777. The diagnostic optimal cut-off point was 1.95 μg/L,with a higher sensitivity and specificity(80.00% and 70.00%,respectively). Conclusion Ps-Tg of no more than 1.95 μg/L can be used to indicate satisfactory clinical outcome in postoperative PTC patients whose ps-Tg was below 10 μg/L.
作者
武标
徐慧琴
汪会
张新新
谯凤
朱书田
Wu Biao;Xu Huiqin;Wang Hui(Dept of Nuclear Medicine,The First Affiliated Hospital of Anhui Medical University,Hefei 230022)
出处
《安徽医科大学学报》
CAS
北大核心
2020年第4期602-606,共5页
Acta Universitatis Medicinalis Anhui
基金
安徽省科技厅科技攻关项目(编号:1704a0802164)。
