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抗甲状腺球蛋白阳性患者良性甲状腺结节高强度聚焦消融术后血清甲状腺球蛋白和抗甲状腺球蛋白的变化。

Changes in serum thyroglobulin and antithyroglobulin shortly following high-intensity focused ablation of benign thyroid nodules in patients with positive antithyroglobulin status.

机构信息

a Department of Surgery , The University of Hong Kong , Hong Kong SAR , China.

b Department of Medicine , The University of Hong Kong , Hong Kong SAR , China.

出版信息

Int J Hyperthermia. 2018;35(1):637-643. doi: 10.1080/02656736.2018.1516302. Epub 2018 Oct 10.

Abstract

BACKGROUND

We aimed to describe changes in serum thyroglobulin (Tg) and anti-Tg autoantibody shortly following high-intensity focused ultrasound (HIFU) ablation in patients with positive anti-Tg status by comparing them with patients with negative anti-Tg and to correlate them with 6-month nodule shrinkage and treatment success.

METHODS

From 2015 to 2017, patients who underwent HIFU ablation of a benign thyroid nodule were analysed. Serum Tg and anti-Tg were checked on treatment day (baseline) and 4 days after treatment. Anti-Tg >99 IU/ml were considered positivity. Percentage Tg or anti-Tg change = [Level on Day-4 - baseline level]/[Baseline level] × 100 while nodule shrinkage was measured by volume reduction ratio (VRR) = [Baseline volume - volume at 6 month]/[Baseline volume] × 100. Treatment success was defined as VRR >50%.

RESULTS

Among the 276 eligible patients, 85 (30.8%) patients were positive for anti-Tg (Group I) while the others (n = 191, 69.2%) were negative (Group II). Relative to group II, Group I had a less significant Tg rise on Day 4 (4121.78 ± 9321.90% vs. 5711.53 ± 23487.20%, p = .013). There was a fall in anti-Tg on day 4 for group I (-11.56 ± 139.69%). This percentage anti-Tg drop significantly correlated with the 6-month VRR (ρ = -0.602, p = .030) but was not a significant factor of treatment success.

CONCLUSIONS

Given the fact that the percentage anti-Tg drop correlated significantly with 6-month nodule shrinkage in group I, monitoring early anti-Tg change may help to predict the 6-month nodule shrinkage in patients with positive anti-Tg.

摘要

背景

本研究旨在通过比较抗甲状腺球蛋白(Tg)抗体阳性和阴性患者,描述 HIFU 消融治疗后短时间内血清 Tg 和抗 Tg 自身抗体的变化,并与 6 个月时的结节缩小和治疗成功相关联。

方法

本研究回顾性分析了 2015 年至 2017 年间接受 HIFU 消融治疗的良性甲状腺结节患者。在治疗日(基线)和治疗后 4 天检测血清 Tg 和抗 Tg。抗 Tg >99 IU/ml 被认为是阳性。Tg 或抗 Tg 的百分比变化=[第 4 天的水平-基线水平]/[基线水平]×100,而结节缩小则通过体积缩小率(VRR)[基线体积-6 个月时的体积]/[基线体积]×100 来测量。治疗成功定义为 VRR>50%。

结果

在 276 例符合条件的患者中,85 例(30.8%)患者抗 Tg 阳性(组 I),其余 191 例(69.2%)患者抗 Tg 阴性(组 II)。与组 II 相比,组 I 在第 4 天的 Tg 升高幅度较小(4121.78±9321.90% vs. 5711.53±23487.20%,p=0.013)。第 4 天组 I 的抗 Tg 下降(-11.56±139.69%)。抗 Tg 的这种百分比下降与 6 个月时的 VRR 显著相关(ρ=-0.602,p=0.030),但不是治疗成功的显著因素。

结论

鉴于组 I 中抗 Tg 百分比下降与 6 个月时的结节缩小显著相关,监测早期抗 Tg 变化可能有助于预测抗 Tg 阳性患者的 6 个月时的结节缩小。

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