中高风险分化型甲状腺癌患者术后血清甲状腺球蛋白水平与临床结局的相关性研究

目的 探究中高风险分化型甲状腺癌(DTC)患者术后血清甲状腺球蛋白(Tg)水平对远期临床结局的预测价值.方法 回顾性分析2011年1月至2019年6月就诊于四川大学华西医院的DTC患者共296例,依据最后一次随访结果 分为3组:A组为存在结构性复发患者、B组为生化反应不全患者、C组为无病生存患者.3组患者均接受甲状腺全...

Correlation between the level of serum thyroglobulin after operation and the clinical outcome in patients with medium-high risk differentiated thyroid cancer

Objective To explore the value of serum thyroglobulin(Tg)level in predicting long-term clinical outcome in patients with medium-high risk differentiated thyroid cancer(DTC).Methods A total of 296 DTC patients admitted to West China Hospital,Sichuan University from January 2011 to June 2019 were retrospectively analyzed.Based on the results of the last follow-up,these patients were divided into three groups:patients having evidence of structural persistence/recurrence were taken as group A,patients having incomplete biochemical response were taken as group B,patients surviving with disease-free were taken as group C.All patients in the three groups received total thyroidectomy and iodine 131(¹³¹I)radiotherapy,and were followed up regularly.The median follow-up time was 45 months(2—120 months).The differences between the levels of post-surgery preablative stimulated Tg(ps-Tg)and non-stimulated Tg(ns-Tg)levels among three groups were compared.Receiver operating characteristic(ROC)curves were drawn to find the optimal thresholds for ps-Tg and ns-Tg to predict patients′disease-free survival,and multivariate Logistic regression analysis was used to identify risk factors of disease persistence or recurrence.Results The median levels of ps-Tg and ns-Tg from high to low were group A,group B,group C(P<0.05).The optimal thresholds of ps-Tg and ns-Tg for predicting clinical outcome were 5.21 ng/mL(AUC=0.956,95%CI:0.929—0.984)and 0.28 ng/mL(AUC=0.930,95%CI:0.901—0.959).Cervical lymph node metastasis(OR=3.076,95%CI:1.438—6.581,P<0.01)and serum ps-Tg level(OR=1.55,95%CI:1.362—1.765,P<0.001)were risk factors for incomplete biochemical response or structural disease recurrence.Besides,when the time of Tg level doubling was less than one year,patients were more prone to have disease structural recurrence.Conclusion The higher stage of lymph node metastasis,postoperative ps-Tg>5.21 ng/mL,ns-Tg<0.28 ng/mL,and the time of Tg doubling<1 year could predict the disease-free survival of patients with medium-high risk DTC.