131I治疗前刺激性Tg对乳头状甲状腺癌远处转移的预测价值

目的 探讨刺激性Tg在乳头状甲状腺癌(PTC)术后、131I治疗前对远处转移的预测价值.方法 231例经过甲状腺全切术拟行131I治疗的PTC患者,根据是否存在远处转移分为M138例,男15例,女23例,平均年龄(43.9±16.3)岁]和M0193例,男60例,女133例,平均年龄(42.4±11.4)岁]2组.用t检验及x2检验观察2组的年龄、性别差异是否有统计学意义,用Mann-Whitney 秩和检验比较2组间Tg水平,通过ROC曲线及最佳诊断界值点(DCP)评估刺激性Tg对远处转移的预测价值.结果 2组的年龄(t=-0.675,P=0.50)、性别(x2=1.02,P=0.31)差异均无统计学意义.2组刺激性Tg水平分别为1.5～17.5 μg/L和93.8～1000.0 μg/L,两者差异有统计学意义(U=787.5,P ＜0.001).Tg的ROC AUC为0.893(95％ CI:0.823～0.962),Tg界值点为52.75 μg/L,对应的灵敏度、特异性分别为78.90％和91.70％.结论 刺激性Tg在PTC全切术后、131I治疗前对PTC的远处转移有重要的预测价值.

The value of pre-ablation stimulated thyroglobulin in predicting distant metastasis of papillary thyroid cancer

Objective To investigate the value of pre-ablation stimulated Tg in predicting distant metastasis of papillary thyroid cancer （PTC）. Methods The study included 231 patients with PTC who had undergone total thyroidectomy and subsequent 131I therapy. Patients were divided into two groups as MI （38 cases, 15 males, 23 females, average age （43.9± 16.3） y） and M0 （193 cases, 60 males, 133 remales, average age （42.4 ± 11.4） y） according to the presence and absence of distant metastases, respectively. T-test andx2 test were used to evaluate the statistical differences between the two groups. The Tg value between M0 and M1 was compared by Mann-Whitney rank-sum test. The ROC curves and diagnostic critical point （DCP） were analyzed to evaluate the predictive value of stimulated Tg. Results There was no significant difference between the two groups in age （ t = - 0. 675, P = 0.50） and gender （X2 = 1.02, P = 0.31 ）. Pre-ablation stimulated Tg was significantly different between the two groups （the Mann-Whitney rank-sum test ： U = 787.5, P 〈 0. 001 ）. Area under the ROC curve for Tg levels was 0. 893 （95% CI： 0. 863 - 0.962）. The cut-off value of DCP of Tg was 52.75 μg/L with a sensitivity of 78.90% and specificity of 91.70%. Conclusion Stimulated Tg may be a useful ＂diagnostic tumor marker＂ for predicting distant metastases of PTC before the first ^131 I ablation therapy.