Chen Zhijiang, Lin Yinghe, Lai Shuiqing, Wang Peiqing, Li Jinlian, Wang Long, Guan Haixia, Kuang Jian
Department of Endocrinology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China.
Endocrine. 2022 May;76(2):369-376. doi: 10.1007/s12020-022-02993-1. Epub 2022 Feb 2.
Distinguishing follicular thyroid carcinoma (FTC) from follicular thyroid adenoma (FTA) before surgery is inherently challenging owing to the lack of malignant features on ultrasound, poor sensitivity of fine-needle biopsy, and the absence of definitive markers. We investigated whether thyroglobulin (Tg), anti-thyroglobulin antibody (TgAb), thyroid peroxidase antibodies (TPOAb), and thyroid stimulating hormone (TSH) can help differentiate FTC from FTA.
Data pertaining to 319 patients with follicular neoplasms were retrospectively analyzed. We compared the serum markers between patients with confirmed FTC and FTA. We also analyzed the prevalence of FTC in different subgroups of patients based on serum marker levels.
TgAb was a risk factor for FTC. Compared to TgAb ≤11.68 IU/mL group, the odds ratio (OR) for FTC in TgAb 11.69-30.50 IU/mL group and TgAb >30.50 IU/mL group were 2.206 (1.114-4.369, P = 0.023) and 3.247 (1.684-6.260, P < 0.001), respectively. The prevalence of malignancy in TgAb >30.50 IU/mL group was significantly higher than in the TgAb ≤11.68 IU/mL group (32.9 vs. 13.1%, P = 0.001). In patients with TgAb (-) status, Tg was another risk factor for FTC. Compared to Tg ≤38.51 ng/mL group, OR of Tg >434.60 ng/mL group was 3.836 (1.625-9.058, P = 0.002); the prevalence of malignancy in the Tg >434.60 ng/mL group was 47.2% and higher than other groups.
TgAb and Tg levels may be useful markers for preoperative differential diagnosis of follicular neoplasms. Higher TgAb and Tg levels were associated with greater malignant risk. Thus, we should be cautious of preoperative TgAb and Tg in follicular neoplasms.
由于超声检查缺乏恶性特征、细针穿刺活检敏感性差以及缺乏明确的标志物，术前区分滤泡状甲状腺癌（FTC）和滤泡状甲状腺腺瘤（FTA）具有很大挑战性。我们研究了甲状腺球蛋白（Tg）、抗甲状腺球蛋白抗体（TgAb）、甲状腺过氧化物酶抗体（TPOAb）和促甲状腺激素（TSH）是否有助于鉴别FTC和FTA。
回顾性分析319例滤泡性肿瘤患者的数据。我们比较了确诊为FTC和FTA患者的血清标志物。我们还根据血清标志物水平分析了不同亚组患者中FTC的患病率。
TgAb是FTC的一个危险因素。与TgAb≤11.68 IU/mL组相比，TgAb 11.69 - 30.50 IU/mL组和TgAb>30.50 IU/mL组FTC的比值比（OR）分别为2.206（1.114 - 4.369，P = 0.023）和3.247（1.684 - 6.260，P < 0.001）。TgAb>30.50 IU/mL组的恶性患病率显著高于TgAb≤11.68 IU/mL组（32.9%对13.1%，P = 0.001）。在TgAb（-）状态的患者中，Tg是FTC的另一个危险因素。与Tg≤38.51 ng/mL组相比，Tg>434.60 ng/mL组的OR为3.836（1.625 - 9.058，P = 0.002）；Tg>434.60 ng/mL组的恶性患病率为47.2%，高于其他组。
TgAb和Tg水平可能是滤泡性肿瘤术前鉴别诊断的有用标志物。较高的TgAb和Tg水平与更高的恶性风险相关。因此，对于滤泡性肿瘤患者，我们应谨慎对待术前的TgAb和Tg。
