摘要
目的探讨术前甲状腺相关血清学检测指标[包括促甲状腺激素(thyroid stimulating hormone,TSH)、甲状腺球蛋白(thyroglobulin,Tg)、抗甲状腺球蛋白抗体(anti-thyroglobulin antibody,TGAb)、甲状腺过氧化物酶抗体(thyroid peroxidase antibody,TPOAb)、促甲状腺激素受体抗体(thyrotropin receptor antibody,TRAb)]与甲状腺乳头状癌临床病理特征的相关性。方法回顾性分析贵州省人民医院2020年1月至12月经手术治疗的272例甲状腺乳头状癌患者的临床资料,比较甲状腺乳头状癌患者的临床病理特征与术前甲状腺相关血清学检测指标的关系。结果TSH×TRAb低表达组患者的BRAF基因V600E突变发生率低于TSH×TRAb高表达组,差异有统计学意义(P<0.01);Tg×TGAb低表达组患者的肿瘤大小小于Tg×TGAb高表达组,颈侧区转移率低于Tg×TGAb高表达组,BRAF基因V600E突变发生率低于Tg×TGAb高表达组,差异均有统计学意义(P<0.05);TGAb/TPOAb低表达组患者的BRAF基因V600E突变发生率低于TGAb/TPOAb高表达组,差异有统计学意义(P<0.05)。受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析结果显示,术前TSH×TRAb值指导甲状腺乳头状癌BRAF基因突变的诊断效能最大(敏感度61.3%,特异性71.7%),其次是TGAb/TPOAb值(敏感度39.2%,特异性76.1%),最后是Tg×TGAb值(敏感度60.9%,特异性53.9%);术前Tg×TGAb值指导甲状腺乳头状癌肿瘤大小的敏感度为61.6%,特异性为64.7%;术前Tg×TGAb值指导甲状腺乳头状癌颈侧区转移的敏感度为60.0%,特异性为73.5%。结论术前TSH×TRAb、Tg×TGAb、TGAb/TPOAb值是甲状腺乳头状癌BRAF基因V600E突变的独立危险因素,对甲状腺乳头状癌BRAF基因V600E突变具有一定的诊断价值。术前Tg×TGAb值对甲状腺乳头状癌肿瘤大小、颈侧区转移具有一定的诊断价值,有助于评估甲状腺乳头状癌的发展及预后。
Objective To explore the correlation between preoperative thyroid-related serological indicators[including thyroid stimulating hormone(TSH),thyroglobulin(Tg),anti-thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb)and thyrotropin receptor antibody(TRAb)]and the clinicopathological features of papillary thyroid cancer.Methods The clinical data of 272 patients with papillary thyroid cancer who underwent surgery in Guizhou Provincial People’s Hospital from January to December 2020 were retrospectively analyzed,and the relationship between the clinicopathological characteristics of papillary thyroid cancer patients and preoperative thyroid-related serological indicators was compared.Results The incidence of BRAF gene V600E mutation in the low TSH×TRAb group was lower than that in the high TSH×TRAb group,and the difference was statistically significant(P<0.01);Tumor size of patients in the low Tg×TGAb group was lower than that in the high Tg×TGAb group,the metastasis rate in the lateral cervical region was lower than that in the high Tg×TGAb group,and the incidence of BRAF gene V600E mutation was lower than that in the high Tg×TGAb group,and the difference was all statistically significant(P<0.05);The incidence of BRAF gene V600E mutation in the low TGAb/TPOAb group was significantly lower than that in the high TGAb/TPOAb group(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that the preoperative TSH×TRAb value guided the diagnosis of BRAF gene V600E mutation in papillary thyroid cancer(with sensitivity was 61.3%,specificity was 71.7%),followed by TGAb/TPOAb value(with sensitivity was 39.2%,specificity was 76.1%),and finally Tg×TGAb(with sensitivity was 60.9%,specificity was 53.9%);The sensitivity and specificity of preoperative Tg×TGAb value in guiding tumor size of papillary thyroid cancer was 61.6%and 64.7%respectively.The sensitivity and specificity of preoperative Tg×TGAb value in guiding lateral cervical region metastasis of papillary thyroid cancer was 60.0%and 73.5%r
作者
陈心悦
田奕
余招焱
CHEN Xinyue;TIAN Yi;YU Zhaoyan(The First Clinical Medical School,Guizhou University of Traditional Chinese Medicine,Guiyang 550025,Guizhou,China;Department of Vascular and Thyroid Surgery,Guizhou Provincial People’s Hospital,Guiyang 550002,Guizhou,China)
出处
《中国现代医生》
2024年第36期41-45,共5页
China Modern Doctor
关键词
甲状腺乳头状癌
甲状腺球蛋白
促甲状腺激素
甲状腺抗体
Papillary thyroid cancer
Thyroglobulin
Thyroid-stimulating hormone(TSH)
Thyroid antibody
