中国耳鼻咽喉头颈外科2024,Vol.31Issue(1) :7-12.DOI:10.16066/j.1672-7002.2024.01.002

血清降钙素在甲状腺髓样癌的诊断、术前评估及术后随访中的临床价值

Clinical value of serum calcitonin in the diagnosis,preoperative evaluation and postoperative follow-up of medullary thyroid cancer

李婷婷 马丙娥 黄驰 徐书杭 武心萍 王建华
中国耳鼻咽喉头颈外科2024,Vol.31Issue(1) :7-12.DOI:10.16066/j.1672-7002.2024.01.002

血清降钙素在甲状腺髓样癌的诊断、术前评估及术后随访中的临床价值

Clinical value of serum calcitonin in the diagnosis,preoperative evaluation and postoperative follow-up of medullary thyroid cancer

李婷婷 1马丙娥 1黄驰 1徐书杭 2武心萍 3王建华1
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作者信息

  • 1. 南京中医药大学附属中西医结合医院甲乳外科,江苏 南京 210028
  • 2. 南京中医药大学附属中西医结合医院内分泌科,江苏 南京 210028
  • 3. 南京中医药大学附属中西医结合医院超声科,江苏 南京 210028
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摘要

目的 探讨血清降钙素(calcitonin,Ctn)对甲状腺髓样癌(medullary thyroid carcinoma,MTC)的诊断效能,术前Ctn与临床病理特征相关性及随访中影响MTC疾病进展的危险因素.方法 系统性回顾2011年11月~2022年11月南京中医药大学附属中西医结合医院收治的50例甲状腺结节患者临床资料,ROC曲线计算Ctn、癌胚抗原(carcinoembryonic antigen,CEA)水平对MTC的诊断效能,单因素、多因素分析MTC中央区淋巴结转移的危险因素,绘制无疾病进展生存曲线预测危险因素.结果 ROC曲线结果显示诊断MTC的术前Ctn截断值为23.81 pg/ml,CEA截断值为3.035 ng/ml.MTC患者的患病年龄、肿瘤直径、术前血清Ctn和CEA水平均高于非MTC患者.Ctn≥289.62 pg/ml是MTC患者中央区淋巴结转移的独立危险因素.生存曲线结果显示侵犯包膜、中央区淋巴结转移、T2级以上是预测疾病进展的危险因素(P<0.05),疾病发生进展的MTC患者术前Ctn较高.结论 血清Ctn在MTC鉴别诊断、术前评估以及术后随访均有重要临床价值.

Abstract

OBJECTIVE To investigate the diagnostic efficacy of serum calcitonin(Ctn)in medullary thyroid cancer(MTC),the correlation between preoperative serum Ctn and clinicopathological features,and the risk factors affecting the progression of MTC disease during follow-up.METHODS The clinical data of 50 patients admitted to the Hospital of Integrated Traditional Chinese and Western Medicine of Nanjing University of Chinese Medicine from 2011 to 2022 were systematically reviewed,the ROC curve calculated the diagnostic efficacy of Ctn and CEA levels on MTC,and the risk factors for lymph node metastasis in the central region of MTC were analyzed in univariate and multivariate,and the survival curve without disease progression was drawn to predict risk factors.RESULTS The ROC curve yields the preoperative cut-off value of Ctn was 23.81 pg/ml and the cut-off value of CEA was 3.035 ng/ml for the diagnosis of MTC.The age of disease,tumor diameter,and preoperative serum Ctn and CEA levels in MTC patients were higher than those in non-MTC patients.Ctn≥289.62 pg/ml was an independent risk factor for central lymph node metastasis in MTC.The survival curve showed that invasion of the capsule,central region metastasis,and TNM stage above T2 were risk factors for predicting disease progression(P<0.05).Patients with MTC who have disease progression have higher preoperative Ctn.CONCLUSION Serum Ctn has important clinical value in the differential diagnosis,preoperative evaluation and postoperative follow-up of MTC.

关键词

甲状腺肿瘤/降钙素/癌胚抗原/诊断/甲状腺髓样癌/淋巴结转移

Key words

Thyroid Neoplasms/Calcitonin/Carcinoembryonic Antigen/Diagnosis/medullary thyroid cancer/lymph node metastasis

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基金项目

南京中医药大学自然科学研究项目(XZR2020022)

出版年

2024
中国耳鼻咽喉头颈外科
中国医疗保健国际交流促进会 北京市耳鼻咽喉科研究所

中国耳鼻咽喉头颈外科

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影响因子:0.667
ISSN:1672-7002
被引量1
参考文献量26
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