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

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

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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)
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