Center of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, NO. 37 Guo Xue Xiang, Chengdu, Sichuan, People's Republic of China.
Department of Ultrasound, West China Hospital, Sichuan University, NO. 37 Guo Xue Xiang, Chengdu, China.
BMC Surg. 2021 Jan 22;21(1):53. doi: 10.1186/s12893-021-01063-z.
To investigate the association between postoperative lymph nodes (LNs) recurrence and distinct serum thyroglobulin (Tg) levels in patients with papillary thyroid carcinoma (PTC).
This study included PTC patients who underwent total thyroidectomy (TT) with at least central neck dissection and then re-operated due to recurrence of LNs between January 2013 and June 2018. These patients were grouped by negative or positive serum Tg levels according to the American Thyroid Association guidelines.
Of the 60 included patients, 49 underwent radioactive iodine (RAI) treatment. Maximum unstimulated Tg (uTg) ≥ 0.2 ng/mL were associated with larger diameter of recurrent LNs (P = 0.027), and higher rate of metastatic LNs (P < 0.001). Serum-stimulated Tg (off-Tg) ≥ 1 ng/mL (P = 0.047) and unstimulated Tg (on-Tg) ≥ 0.2 ng/Ml (P = 0.013) were associated with larger diameter of recurrent LNs. Number of metastatic LNs ≥ 8 was an independent predictor for postoperative maximum uTg ≥ 0.2 ng/mL (OR = 8.767; 95% CI = 1.392-55.216; P = 0.021). Ratio of metastatic LNs ≥ 25% was an independent predictor for off-Tg ≥ 1 ng/mL (OR = 20.997; 95% CI = 1.649-267.384; P = 0.019).
Postoperative Tg-positive status was associated with larger size of recurrent LNs. Number of metastatic LNs ≥ 8 and ratio of metastatic LNs ≥ 25% were independent predicators for uTg-positive and off-Tg-positive status, respectively.
研究甲状腺乳头状癌（PTC）患者术后淋巴结（LN）复发与不同血清甲状腺球蛋白（Tg）水平之间的关系。
本研究纳入了 2013 年 1 月至 2018 年 6 月期间因 LN 复发而再次接受手术的接受全甲状腺切除术（TT）联合至少中央颈部清扫术的 PTC 患者。根据美国甲状腺协会指南，根据血清 Tg 水平将这些患者分为阴性或阳性组。
在 60 例纳入的患者中，49 例接受了放射性碘（RAI）治疗。最大未刺激 Tg（uTg）≥0.2ng/ml 与复发性 LN 直径较大（P=0.027）和转移性 LN 比例较高（P<0.001）相关。血清刺激 Tg（off-Tg）≥1ng/ml（P=0.047）和未刺激 Tg（on-Tg）≥0.2ng/ml（P=0.013）与复发性 LN 直径较大相关。转移性 LN 数量≥8 个是术后最大 uTg≥0.2ng/ml 的独立预测因素（OR=8.767；95%CI=1.392-55.216；P=0.021）。转移性 LN 比例≥25%是 off-Tg≥1ng/ml 的独立预测因素（OR=20.997；95%CI=1.649-267.384；P=0.019）。
术后 Tg 阳性状态与复发性 LN 大小有关。转移性 LN 数量≥8 个和转移性 LN 比例≥25%分别是 uTg 阳性和 off-Tg 阳性的独立预测因素。
