摘要
目的探讨细针穿刺洗脱液甲状腺球蛋白(thyroglobulin in fine-needle aspirate fluid,FNA-Tg)与血清甲状腺球蛋白(thyroglobulin,Tg)的比值诊断分化型甲状腺癌(differentiated thyroid cancer,DTC)术后^(131)I治疗后颈部淋巴结转移的价值,并计算FNA-Tg及FNA-Tg/血清Tg诊断颈部淋巴结转移的最佳阈值。方法选择在2018年11月至2021年3月于桂林医学院附属医院诊断为DTC并同时行甲状腺全切术及^(131)I治疗的患者114例,在随访过程中,超声共发现可疑淋巴结114个,以病理结果为金标准,比较FNA-Tg、血清Tg及FNA-Tg/血清Tg诊断淋巴结转移的效能,并采用受试者工作特征曲线(receiver operating characteristic curve,ROC)计算FNA-Tg、FNA-Tg/血清Tg判断颈部淋巴结转移的最佳阈值。结果(1)淋巴结转移组血清Tg水平为1.86(0.05,60.65)ng/mL,转移阴性组的血清Tg水平为0.11(0.04,3.20)ng/mL,组间比较,Z=-2.631,P=0.009,差异有统计学意义;淋巴结转移组FNA-Tg水平为500(0.98,500)ng/mL,转移阴性组的FNA-Tg水平为0.04(0.04,0.04)ng/mL,组间比较,Z=-8.049,P<0.001,差异有统计学意义。(2)FNA-Tg诊断颈部淋巴结转移的灵敏度、准确度、假阴性率与血清Tg对比,差异有统计学意义(χ^(2)=8.345、4.269、8.345,P=0.004、0.039、0.004),FNA-Tg/血清Tg诊断颈部淋巴结转移的灵敏度、准确度、假阴性率与血清Tg对比,差异均有统计学意义(χ^(2)=23.727、17.464、23.727,P<0.001、<0.001、<0.001),FNA-Tg/血清Tg诊断颈部淋巴结转移的灵敏度、准确度、假阴性率与FNA-Tg对比,差异有统计学意义(χ^(2)=5.497、5.083、5.497,P=0.019、0.024、0.019)。(3)114个淋巴结的FNA-Tg根据淋巴结转移阳性及转移阴性分组进行ROC曲线分析时,曲线下面积为0.95,最佳诊断阈值为0.37,灵敏度为93%,特异性为87%;114个淋巴结的FNA-Tg/血清Tg根据淋巴结转移阳性及转移阴性分组进行ROC曲线分析时,曲线下面积为0.905,最佳诊断阈值为1.02,灵敏度为93%,特异性为
Objective To investigate the value of the ratio of FNA-Tg(thyroglobulin in fine-needle aspirate fluid)to serum thyroglobulin(Tg)in the diagnosis of cervical lymph node metastasis after ^(131)I postoperative treatment for DTC(differentiated thyroid cancer),and to identify the optimal threshold of FNA-Tg and FNA-Tg/serum Tg in the diagnosis of cervical lymph node metastasis.Methods A total of 114 patients who were diagnosed with DTC and received total thyroidectomy and ^(131)I treatment in the Affiliated Hospital of Guilin Medical College from November,2018 to March,2021 were selected for the study.During the follow-up period,a total of 114 suspected lymph nodes were found by ultrasound,and pathological results were collected as the gold standard.We compared values of FNA-Tg,serum Tg and FNA-Tg/Tg serum in the diagnosis of lymph node metastasis,and drew ROC(receiver operating characteristic)curve to identify the optimal threshold value of FNA-Tg and FNA-Tg/serum Tg to judge cervical lymph node metastasis.Results(1)Serum Tg level of the lymph node metastasis group was 1.86(0.05,60.65)ng/mL,and serum Tg level of the metastasis negative group was 0.11(0.04,3.20)ng/mL.The difference between groups was statistically significant.FNA-Tg level of the lymph node metastasis group was 500(0.98,500)ng/mL,and FNA-Tg level of the metastasis negative group was 0.04(0.04,0.04)ng/mL(P<0.001).There was a significant difference between the two groups(P<0.05).(2)The sensitivity,accuracy and false negative rate of FNA-Tg in the diagnosis of cervical lymph node metastasis were compared with serum Tg,and the differences were statistically significant(χ^(2)=8.345,4.269,8.345,P=0.004,0.039,0.004).Compared with serum Tg,the sensitivity,accuracy and false negative rate of FNA-Tg/serum Tg in the diagnosis of cervical lymph node metastasis showed statistically significant differences(χ^(2)=23.727,17.464,23.727,P<0.001,<0.001,<0.001).The sensitivity,accuracy and false negative rate of FNA-Tg/serum Tg in the diagnosis of cervical lymph node me
作者
孙文杰
卢彦祺
牟兴宇
朱卓豪
秦洋洋
崇维霞
付巍
SUN Wenjie;LU Yanqi;MU Xingyu;ZHU Zhuohao;QIN Yangyang;CHONG Weixia;FU Wei(Department of Nuclear Medicine,Affiliated Hospital of Guilin Medical College,Guilin 541001,China)
出处
《标记免疫分析与临床》
CAS
2021年第12期2017-2022,共6页
Labeled Immunoassays and Clinical Medicine
基金
广西高校中青年教师科研基础能力提升项目(编号:2021KY0488)。
