目的 探讨甲状腺癌患者血清糖类抗原242(CA242)在甲状腺癌中的临床应用价值,为甲状腺癌的诊疗提供参考.方法 筛选141例分化型甲状腺癌患者(甲状腺癌组)、82例甲状腺结节患者(甲状腺结节组)作为研究对象,24例健康查体者作为对照组,应用康乃格试剂采用ELISA方法检测各组CA242,比较各组受试者间的血清CA242水平,分析血清CA242对甲状腺癌诊断的特异性、灵敏度、阳性预测值、阴性预测值,并绘制受试者工作特征曲线(receiver operating characteristic curve,ROC),分析CA242的临床价值.结果 甲状腺癌组血清CA242水平高于甲状腺结节组和健康对照组,差异具有统计学意义(P＜0.05).CA242对甲状腺癌诊断的灵敏度为29.8％、特异性为92.7％、阳性预测值87.5％、阴性预测值为43.4％,ROC曲线结果显示,曲线下面积(area under the curve,AUC)为0.626,差异具有统计学意义(P＜0.05).随访中,2例CA242升高的甲状腺结节患者经组织细胞学检查确诊为甲状腺癌.结论 对于甲状腺结节患者,B超检查为主要手段,同时结合血CA242检测作为补充,可助于甲状腺癌的诊断.
A Study on the Clinical Value of Serum CA242 in ThyroidCancer
Objective To investigate the diagnostic value of serum carbohydrate antigen 242(CA242)in thyroid cancer patients,and to provide references for the clinical diagnosis and treatment of thyroid cancer.Methods A total of 141 patients with differentiated thyroid cancer(thyroid cancer group)and 82 patients with thyroid nodules(thyroid nodule group)were enrolled as research objects,while 24 healthy individuals were selected as the control group.Serum CA242 levels of each groups were compared,and the specificity,sensitivity,positive predictive value and negative predictive value of serum CA242 for the diagnosis of thyroid cancer were analyzed.The subject operating characteristic curve(ROC)was drawn to evaluate the diagnostic value of CA242.Results The serum CA242 level in the thyroid cancer group was significantly higher than that in the thyroid nodule group and control group(P＜0.05).The sensitivity of CA242 for the diagnosis of thyroid cancer was 29.8％,while the specificity was 92.7％,the positive predictive value was 87.5％,and the negative predictive value was 43.4％.ROC curve results showed that the area under the curve(AUC)was 0.626,and the difference was statistically significant(P＜0.05).During follow-up,2 patients with thyroid nodules with elevated CA242 were diagnosed as thyroid cancer by histological and cytological examination.Conclusion For patients with thyroid nodules,B-ultrasound examination is the main method.When combined with blood CA242 detection as a supplement approach,it can further improve the diagnosis accuracy of thyroid cancer.
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