首页|血清TgAb、TPOAb在甲状腺微小乳头状癌诊疗中的临床价值

血清TgAb、TPOAb在甲状腺微小乳头状癌诊疗中的临床价值

Clinical value of serum TgAb and TPOAb in diagnosis and treatment of papillary thyroid microcarcinoma

扫码查看
目的 探讨血清甲状腺球蛋白抗体(TgAb)和甲状腺过氧化物酶抗体(TPOAb)在甲状腺微小乳头状癌(PTMC)诊疗中的临床价值.方法 选取2012年8月至2021年10月于该院接受手术治疗的346例甲状腺结节患者为研究对象,根据术后病理结果分为良性结节组、PTMC组和非微小甲状腺乳头状癌(PTC)组.收集患者一般资料、手术前后甲状腺功能指标[游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、促甲状腺激素(TSH)、TgAb、TPOAb],观察术后肿瘤复发或淋巴结转移情况,分析血清TgAb、TPOAb与PTMC患病风险及预后的关系.结果 PTMC组和非微小PTC组TgAb阳性率明显高于良性结节组(P<0.05),各组TPOAb阳性率比较差异无统计学意义(P>0.05).PTMC组与非微小PTC组相比,仅TSH水平升高(P<0.05).多因素logistic回归分析显示,患者年龄偏小、TSH升高、TgAb阳性是PTMC和非微小PTC的独立危险因素(P<0.05).但PTC的患病风险不随TgAb滴度增加而增加.PTMC组和非微小PTC组术后1个月内TgAb阳性率较术前无明显变化,术后1年均有所下降(P<0.05);术后TPOAb阳性率较术前均有下降,但差异无统计学意义(P>0.05).PTMC组4例出现肿瘤复发或淋巴结转移,复发或转移时TgAb水平较术后第1次随访分别上升88.4%、49.5%、5.7%、84.0%,3例TPOAb水平较术后第1次随访分别上升51.6%、30.0%、2.9%,1例下降53.9%.PTMC组随访中有11例患者出现颈部淋巴结肿大,出现病情变化时TgAb、TPOAb水平较前无统计学差异(P>0.05).结论 TgAb阳性是PTMC的危险因素,在PT-MC诊疗过程中可定期随访;TPOAb的特异性无TgAb好,病程中可选择适当随访.
Objective To investigate the clinical value of thyroid globulin antibody(TgAb)and thyroid peroxidase antibody(TPOAb)in the diagnosis and treatment of papillary thyroid microcarcinoma(PTMC).Methods A total of 346 patients with thyroid nodules who underwent surgical treatment in the hospital from August 2012 to October 2021 were selected as the research objects.According to the postoperative pathologi-cal results,the patients were divided into the benign nodule group,PTMC group and non-micro papillary thy-roid carcinoma(PTC)group.The general data of the patients and thyroid function indexes[free triiodothyro-nine(FT3),free tetraiodothyronine(FT4),thyroid stimulating hormone(TSH),TgAb and TPOAb]before and after operation were collected,the tumor recurrence or lymph node metastasis after operation were ob-served,and the relationship between serum TgAb and TPOAb and the risk and prognosis of PTMC was ana-lyzed.Results The positivity rate of TgAb in the PTMC and non-micro PTC groups was significantly higher than that in the benign nodule group(P<0.05).The TPOAb positivity rate was not significantly different among the three groups(P>0.05).Only the TSH level in the PTMC group was higher than that in the non-micro PTC group(P<0.05).Multivariate logistic analysis showed that younger age,higher TSH and positive TgAb were independent risk factors for PTMC and non-micro PTC(P<0.05).However,the risk of PTC didn't increase with increasing TgAb titres.The positivity rate of TgAb in the PTMC and non-micro PTC groups didn't change significantly within one month after operation,but decreased in one year after operation(P<0.05).The TPOAb positivity rate decreased after operation,but the difference was not statistically sig-nificant(P>0.05).In the PTMC group,four cases had tumor recurrence or lymph node metastasis,and the TgAb level increased by 88.4%,49.5%,5.7%and 84.0%respectively when the tumor recurred or metasta-sized.Among them,the TPOAb level increased by 51.6%,30.0%and 2.9%respectively in three cases and decreased by 53.9%in one case.In the PTMC group,there were 11 patients with cervical lymph node enlarge-ment,and there was no statistical difference in TgAb and TPOAb levels when the condition changed(P>0.05).Conclusion TgAb is a risk factor for PTMC,and can be followed up regularly during the diagnosis and treatment of PTMC.The specificity of TPOAb is not as good as that of TgAb,and appropriate follow-up can be chosen during the course of the disease.

papillary thyroid microcarcinomapapillary thyroid carcinomathyroid globulin antibodythyroid peroxidase antibody

邓文珍、陈诚、凌冰、赵莉、郑丽、周贤群、梁倩、易吉秀

展开 >

重庆市黔江中心医院 内分泌科,重庆 409000

重庆市黔江中心医院 普外科,重庆 409000

甲状腺微小乳头状癌 甲状腺乳头状癌 甲状腺球蛋白抗体 甲状腺过氧化物酶抗体

重庆市科卫联合医学科研项目重庆市自然科学基金项目

2020FYYX029CSTB2022NSCQ-MSX1573

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(5)
  • 25