Wang Lina, Li Hao, Yang Zhongyuan, Guo Zhuming, Zhang Quan
Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China State Key Laboratory of Oncology in South China, Guangzhou, China.
Department of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China State Key Laboratory of Oncology in South China, Guangzhou, China
Otolaryngol Head Neck Surg. 2015 Jul;153(1):15-9. doi: 10.1177/0194599815579877. Epub 2015 Apr 16.
This study was designed to assess the efficiency of the serum thyrotropin to thyroglobulin ratio for thyroid nodule evaluation in euthyroid patients.
Cross-sectional study.
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China.
Retrospective analysis was performed for 400 previously untreated cases presenting with thyroid nodules. Thyroid function was tested with commercially available radioimmunoassays. The receiver operating characteristic curves were constructed to determine cutoff values. The efficacy of the thyrotropin:thyroglobulin ratio and thyroid-stimulating hormone for thyroid nodule evaluation was evaluated in terms of sensitivity, specificity, positive predictive value, positive likelihood ratio, negative likelihood ratio, and odds ratio.
In receiver operating characteristic curve analysis, the area under the curve was 0.746 for the thyrotropin:thyroglobulin ratio and 0.659 for thyroid-stimulating hormone. With a cutoff point value of 24.97 IU/g for the thyrotropin:thyroglobulin ratio, the sensitivity, specificity, positive predictive value, positive likelihood ratio, and negative likelihood ratio were 78.9%, 60.8%, 75.5%, 2.01, and 0.35, respectively. The odds ratio for the thyrotropin:thyroglobulin ratio indicating malignancy was 5.80. With a cutoff point value of 1.525 µIU/mL for thyroid-stimulating hormone, the sensitivity, specificity, positive predictive value, positive likelihood ratio, and negative likelihood ratio were 74.0%, 53.2%, 70.8%, 1.58, and 0.49, respectively. The odds ratio indicating malignancy for thyroid-stimulating hormone was 3.23.
Increasing preoperative serum thyrotropin:thyroglobulin ratio is a risk factor for thyroid carcinoma, and the correlation of the thyrotropin:thyroglobulin ratio to malignancy is higher than that for serum thyroid-stimulating hormone.
本研究旨在评估血清促甲状腺激素与甲状腺球蛋白比值在评估甲状腺功能正常患者甲状腺结节中的效能。
横断面研究。
中山大学肿瘤防治中心，华南肿瘤学国家重点实验室。
对400例既往未经治疗的甲状腺结节患者进行回顾性分析。采用市售放射免疫分析法检测甲状腺功能。绘制受试者工作特征曲线以确定临界值。从灵敏度、特异度、阳性预测值、阳性似然比、阴性似然比和比值比等方面评估促甲状腺激素与甲状腺球蛋白比值及促甲状腺激素对甲状腺结节评估的效能。
在受试者工作特征曲线分析中，促甲状腺激素与甲状腺球蛋白比值的曲线下面积为0.746，促甲状腺激素的曲线下面积为0.659。促甲状腺激素与甲状腺球蛋白比值的临界值为24.97 IU/g时，灵敏度、特异度、阳性预测值、阳性似然比和阴性似然比分别为78.9%、60.8%、75.5%、2.01和0.35。促甲状腺激素与甲状腺球蛋白比值提示恶性肿瘤的比值比为5.80。促甲状腺激素的临界值为1.525 μIU/mL时，灵敏度、特异度、阳性预测值、阳性似然比和阴性似然比分别为74.0%、53.2%、70.8%、1.58和0.49。促甲状腺激素提示恶性肿瘤的比值比为3.23。
术前血清促甲状腺激素与甲状腺球蛋白比值升高是甲状腺癌的危险因素，且促甲状腺激素与甲状腺球蛋白比值与恶性肿瘤的相关性高于血清促甲状腺激素。
