血清甲状腺球蛋白及其抗体水平对甲状腺癌伴发桥本病患者癌转移的预测价值

目的：探讨血清甲状腺球蛋白(Tg)及抗甲状腺球蛋白抗体(TgAb)水平对分化型甲状腺癌伴发桥本甲状腺炎患者癌转移的预测价值。方法选取2008年1月至2012年6月我院收治的90例分化型甲状腺癌伴发桥本甲状腺炎的患者，甲状腺全切术联合碘消融治疗后随访3年收集癌转移情况。分析不同血清Tg水平下TgAb阳性（>40 kIU/L)预测患者有无癌转移的危险度比值(OR)。结果 Tg≤1μg/L组患者中，TgAb阳性相对于阴性患者的癌转移危险度(OR)值为27.0（95%CI：4.02~181.4），TgAb水平与甲状腺癌癌转移高度相关；1μg/L100μg/L组患者均为TgAb阴性，TgAb水平与甲状腺癌癌转移无相关。结论对于Tg≤1μg/L的老年分化型甲状腺癌伴发桥本甲状腺炎患者，TgAb阳性(>40 kIU/L)预测甲状腺癌转移的价值较高。

Predictive value of serum thyroglobulin and antithyrogloblin antibody level on metastasis in patients of thyroid carcinoma complicated with Hashimoto's thyroiditis

Objective To study the predictive value of thyroglobulin (Tg) and antithyrogloblin antibody (TgAb) level on metastasis in patients of differentiated thyroid carcinoma (DTC) complicated with Hashimoto's thyroid-itis. Methods Ninety patients with DTC complicated with Hashimoto's thyroiditis in our hospital from January 2008 to June 2012 were selected, which were treated with total thyroidectomy combined with radioactive iodine ablation and were then followed up for three years to collect data of cancer metastasis. The patients were divided into four groups (ac-cording to the level of Tg):Tg≤1μg/L group, 1μg/L100μg/L group. Odds ratio (OR) was used to evaluate the value of TgAb positive (>40 kIU/L) for predicting cancer metastasis in patients with different levels of serum Tg. Results In Tg≤1μg/L group, the OR was 27.0 (95%CI:4.02~181.4) for TgAb positive to TgAb negative in predicting cancer metastasis, and the levels of TgAb was highly correlated with the metastasis of thyroid carcinoma. In 1μg/L100μg/L group, the patients were all TgAb negative, and TgAb levels had no correlation with metastasis of thyroid cancer. Conclusion The value of TgAb positive (>40 kIU/L) in predicting cancer metastasis is relatively high for elderly patients of differentiated thyroid carci-noma complicated with Hashimoto's thyroiditis with Tg≤1μg/L.