Department of Thyroid Surgery, General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Department of Critical Care Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China.
Endocr Pract. 2021 Apr;27(4):306-311. doi: 10.1016/j.eprac.2020.10.017. Epub 2020 Dec 15.
To compare the thyroid autoantibody status of patients with papillary thyroid cancer (PTC) and benign nodular goiter as well as possible associations between thyroid autoantibodies and clinicopathologic features of PTC.
A total of 3934 participants who underwent thyroidectomy were enrolled in this retrospective study. Patients were divided into PTC and benign nodule groups according to pathological diagnosis. Based on the preoperative serum antibody results, PTC patients were divided into thyroid peroxidase antibody (TPOAb)-positive, thyroglobulin antibody (TgAb)-positive, dual TPOAb- and TgAb-positive, or antibody-negative groups.
Of the 3934 enrolled patients, 2926 (74.4%) were diagnosed with PTC. Multivariate regression analyses suggested that high thyroid-stimulating hormone levels (adjusted odds ratio [OR] = 1.732, 95% CI [1.485-2.021], P < .001), positive TgAb (adjusted OR = 1.768, 95% CI [1.436-2.178], P < .001), and positive TPOAb (adjusted OR = 1.452, 95% CI [1.148-1.836], P = .002) were independent risk factors for predicting malignancy of thyroid nodules. Multinomial multiple logistic regression analyses indicated that positive TPOAb alone was an independent predictor of less central lymph node metastasis in PTC patients (adjusted OR = 0.643, 95% CI [0.448-0.923], P = .017), whereas positive TgAb alone was significantly associated with less extrathyroidal extension (adjusted OR = 0.778, 95% CI [0.622-0.974], P = .028). PTC patients with dual-positive TPOAb and TgAb displayed a decreased incidence of extrathyroidal extension (adjusted OR = 0.767, 95% CI [0.623-0.944], P = .012) and central lymph node metastasis (adjusted OR = 0.784, 95% CI [0.624-0.986], P = .037).
Although preoperative positive TPOAb and TgAb are independent predictive markers for PTC, they are also associated with better clinicopathologic features of PTC.
比较甲状腺乳头状癌(PTC)患者与良性结节性甲状腺肿患者的甲状腺自身抗体状态,以及甲状腺自身抗体与 PTC 临床病理特征之间的可能关联。
本回顾性研究共纳入 3934 名接受甲状腺切除术的患者。根据病理诊断,患者被分为 PTC 和良性结节组。基于术前血清抗体结果,将 PTC 患者分为甲状腺过氧化物酶抗体(TPOAb)阳性、甲状腺球蛋白抗体(TgAb)阳性、TPOAb 和 TgAb 双阳性和抗体阴性组。
在纳入的 3934 名患者中,2926 名(74.4%)被诊断为 PTC。多变量回归分析表明,高促甲状腺激素水平(调整后的优势比 [OR] 1.732,95%置信区间 [1.485-2.021],P <.001)、阳性 TgAb(调整后的 OR 1.768,95%置信区间 [1.436-2.178],P <.001)和阳性 TPOAb(调整后的 OR 1.452,95%置信区间 [1.148-1.836],P =.002)是预测甲状腺结节恶性的独立危险因素。多项多项逻辑回归分析表明,TPOAb 单独阳性是 PTC 患者中央淋巴结转移程度较低的独立预测因素(调整后的 OR 0.643,95%置信区间 [0.448-0.923],P =.017),而 TgAb 单独阳性与甲状腺外侵犯程度较低显著相关(调整后的 OR 0.778,95%置信区间 [0.622-0.974],P =.028)。TPOAb 和 TgAb 双阳性的 PTC 患者甲状腺外侵犯程度降低(调整后的 OR 0.767,95%置信区间 [0.623-0.944],P =.012)和中央淋巴结转移(调整后的 OR 0.784,95%置信区间 [0.624-0.986],P =.037)发生率降低。
尽管术前 TPOAb 和 TgAb 阳性是 PTC 的独立预测标志物,但它们也与 PTC 的更好临床病理特征相关。