Zhang Xuefeng, Zhang Xueqi, Chang Zhexing, Wu Cuicui, Guo Hang
Department of Nuclear Medicine, Affiliated Hospital, Beihua University, Jilin, China.
J BUON. 2018 Sep-Oct;23(5):1467-1471.
To investigate the feasibilities and clinical values of thyroid-stimulating hormone (TSH) and thyroid autoantibodies in predicting differentiated thyroid cancer (DTC).
500 patients with thyroid nodules who underwent surgery for the first time in our hospital from January 2014 to December 2016 were selected, including 250 patients definitely diagnosed pathologically with DTC and 250 patients definitely diagnosed with benign thyroid nodules after operation. Serum thyroglobulin antibody (TgAb), thyroid peroxidase antibody (TPOAb) and TSH levels before operation were evaluated in both groups. According to the reference ranges of TgAb and TPOAb, they were divided into negative and positive groups. According to the TSH reference range, they were divided into decreased, normal and increased groups. Statistical analyses were conducted, respectively.
The serum TgAb level in the DTC group was significantly increased compared with that in benign thyroid nodule group (p=0.01). The positive rate of TgAb in DTC group was also significantly higher than that in benign thyroid nodule group (p<0.01). The level of serum TPOAb in the DTC group was not significantly different from that in the benign thyroid nodule group (p=0.25). The level of serum TSH in the DTC group was significantly increased compared with that in the benign thyroid nodule group (p<0.01). There was a statistically significant difference in the comparison of the distribution of TSH between the DTC group and benign thyroid nodule group (p<0.01). Univariate analysis showed that TgAb and TSH were correlated with DTC. Multivariate logistic regression analysis results showed that serum positive TgAb and increased TSH wre significantly correlated with DTC. TSH level in DTC with cervical lymph node metastasis group was significantly increased compared with DTC without such metastasis group (p<0.01).
Increased levels of serum TgAb and TSH may be risk factors for DTC. Whether the two indicators can be used as predictors of DTC screening needs to be confirmed in large-sample prospective trials. Increased serum TSH level is closely related to DTC with cervical lymph node metastasis.
探讨促甲状腺激素（TSH）及甲状腺自身抗体预测分化型甲状腺癌（DTC）的可行性及临床价值。
选取2014年1月至2016年12月在我院首次接受手术治疗的500例甲状腺结节患者，其中病理确诊为DTC的患者250例，术后病理确诊为良性甲状腺结节的患者250例。检测两组患者术前血清甲状腺球蛋白抗体（TgAb）、甲状腺过氧化物酶抗体（TPOAb）及TSH水平。根据TgAb和TPOAb的参考范围，将其分为阴性组和阳性组。根据TSH参考范围，将其分为降低组、正常组和升高组。分别进行统计学分析。
DTC组血清TgAb水平显著高于良性甲状腺结节组（p = 0.01）。DTC组TgAb阳性率也显著高于良性甲状腺结节组（p < 0.01）。DTC组血清TPOAb水平与良性甲状腺结节组相比差异无统计学意义（p = 0.25）。DTC组血清TSH水平显著高于良性甲状腺结节组（p < 0.01）。DTC组与良性甲状腺结节组TSH分布比较差异有统计学意义（p < 0.01）。单因素分析显示，TgAb和TSH与DTC相关。多因素logistic回归分析结果显示，血清TgAb阳性和TSH升高与DTC显著相关。有颈部淋巴结转移的DTC组TSH水平显著高于无颈部淋巴结转移的DTC组（p < 0.01）。
血清TgAb和TSH水平升高可能是DTC的危险因素。这两项指标能否作为DTC筛查的预测指标，有待大样本前瞻性试验证实。血清TSH水平升高与有颈部淋巴结转移的DTC密切相关。
