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目的:探讨完全切除甲状腺组织后血清甲状腺球蛋白(TG)阴性时,血清抗甲状腺球蛋白抗体(Tg Ab)对分化型甲状腺癌(DTC)术后复发/转移的预测价值。方法:选择2013年4月-2015年4月我院收治的57例完全切除甲状腺组织,TG阴性且Tg Ab阳性的DTC患者临床病历资料,并将其分为复发/转移组(20例)和无复发/转移组(37例)。采用放射免疫分析法测定并比较两组患者的血清TG、Tg Ab水平,分析Tg Ab对DTC复发/转移诊断的灵敏度、特异度、阳性预测值以及阴性预测值,采用Logistic回归分析DTC复发/转移的独立危险因素。结果:复发/转移组的血清Tg Ab水平为72~3850 IU/m L,高于无复发/转移组的18~3638 IU/m L,差异有统计学意义(P<0.05)。其中Tg Ab对DTC复发/转移诊断的灵敏度为85.71%,特异度为83.33%,阳性预测值为75.00%,阴性预测值为90.91%。经Logistic回归分析发现,Tg Ab水平为100≤Tg Ab<204 IU/m L、204≤Tg Ab≤1000IU/m L、>1000 IU/m L是DTC复发/转移的独立危险因素(OR=1.267,2.853,6.791,P<0.05)。结论:Tg Ab可作为评估完全切除甲状腺组织、TG阴性且Tg Ab阳性的DTC患者复发/转移的重要指标,其值越高,复发/转移发生的可能性越大。
Objective: To investigate the predictive value of serum anti-thyroglobulin antibody (Tg Ab) on the recurrence / metastasis of differentiated thyroid carcinoma (DTC) after complete thyroidectomy with negative serum thyroglobulin (TG). Methods: From April 2013 to April 2015, 57 clinical data of DTC patients with complete thyroidectomy, TG negative and Tg Ab positive were selected and divided into recurrence / metastasis group (20 cases) and control group No recurrence / metastasis (37 cases). Radioimmunoassay was used to measure and compare the serum levels of TG and Tg Ab in the two groups. The sensitivity, specificity, positive predictive value and negative predictive value of Tg Ab in the diagnosis of DTC recurrence / metastasis were analyzed. Logistic regression analysis was used to analyze the relapse / metastasis of DTC Of independent risk factors. Results: The level of serum Tg Ab in relapse / metastasis group was 72-3850 IU / m L, which was significantly higher than that in the non-recurrence / metastasis group (18-3638 IU / m L, P <0.05). Among them, Tg Ab had 85.71% sensitivity, 83.33% specificity, 75.00% positive predictive value, and 90.91% negative predictive value for the diagnosis of DTC recurrence / metastasis. Logistic regression analysis showed that Tg Ab levels were independent predictors of DTC recurrence / metastasis (OR = 1.267), with 100≤Tg Ab <204 IU / m L, 204≤Tg Ab≤1000IU / m L, and> 1000 IU / , 2.853, 6.791, P <0.05). CONCLUSION: Tg Ab can be used as an important index for assessing recurrence / metastasis in patients with totally resected thyroid tissue, TG negative and Tg Ab positive DTC. The higher the value, the greater the possibility of recurrence / metastasis.