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[儿童及青少年甲状腺乳头状癌血清甲状腺球蛋白抗体和甲状腺过氧化物酶抗体与临床病理特征的相关性]

[Correlations of serum TgAb and TPOAb and clinicopathological features of PTC in children and adolescents].

作者信息

Huang D M, Zhi J T, Zhang J M, Zheng X Q, Zhao J Z, Wei S F, Gao M

机构信息

Department of Thyroid and Neck Oncology, Cancer Hospital of Tianjin Medical University, National Cancer Research Center, Tianjin Key Laboratory of Cancer Prevention, Tianjin Medical Research Center for Malignant Tumor, Tianjin 300060, China.

Department of Thyroid and Neck Oncology, Cancer Hospital of Tianjin Medical University, National Cancer Research Center, Tianjin Key Laboratory of Cancer Prevention, Tianjin Medical Research Center for Malignant Tumor, Tianjin 300060, China Department of Breast and Thyroid Surgery, Tianjin People's Hospital, Tianjin 300191, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022 Dec 7;57(12):1418-1425. doi: 10.3760/cma.j.cn115330-20220927-00581.

Abstract

To analyze the correlations between serum thyroglobulin antibody (TgAb) and thyroid peroxidase antibody (TPOAb) and clinicopathological features in children and adolescents with papillary thyroid carcinoma (PTC). A retrospective analysis was conduced on the clinicopathological data of children and adolescents (age≤21 years old) with PTC admitted to Tianjin Medical University Cancer Hospital from 2011 to 2019, and then, we used χ test or Fisher's exact probability test to compare the differences in clinicopathological characteristics between groups with different TgAb and TPOAb status and multivariate logistic regression model analysis to evaluate independent predictors of cervical lymph node metastasis. A total of 304 patients, including 89 males and 215 females, aged 5-21 years (median age 19 years), were enrolled in this study. The comparison between groups with different TgAb and TPOAb status showed that there were significant differences in gender, preoperative thyroglobulin (Tg) level, primary tumor location, number of primary tumors and maximum tumor diameter (all <0.05), which suggested that TgAbgroup (=81) and TPOAbgroup (=84) had relatively better primary tumor characteristics. Patitents with TgAband TPOAbwere more common in females and their preoperative Tg level was mostly within the normal range, and there were significant differences in primary tumor location, number of primary tumors and maximum tumor diameter between TgAband TgAb(223 cases) groups (all <0.05). There was significant difference in the maximum tumor diameter between TPOAband TPOAb(220 cases) groups (<0.05). Analysis of risk factors for cervical lymph node metastasis showed that independent risk factors for central lymph node metastasis were maximum tumor diameter>2 cm (=2.84, 95%: 1.59-5.07, <0.001) and extra-thyroid extension (=0.32, 95%: 0.17-0.60, <0.001), and independent risk factors for lateral neck lymph node metastasis included age≤14 years old (=0.34, 95%: 0.18-0.67, =0.002), preoperative Tg(=2.16, 95%: 1.10-4.24, =0.026) and maximum tumor diameter>2 cm (=3.99, 95%: 2.33-6.82, <0.001). It is recommended to test routinely serum TgAb and TPOAb before surgery in children and adolescents with PTC. Preoperative Tg, age≤14 years, maximum tumor diameter>2 cm, and extra-thyroid extension are risk factors for cervical lymph node metastasis.

摘要

分析儿童及青少年甲状腺乳头状癌(PTC)患者血清甲状腺球蛋白抗体(TgAb)和甲状腺过氧化物酶抗体(TPOAb)与临床病理特征之间的相关性。回顾性分析2011年至2019年在天津医科大学肿瘤医院收治的年龄≤21岁的儿童及青少年PTC患者的临床病理资料,采用χ²检验或Fisher确切概率法比较不同TgAb和TPOAb状态组间临床病理特征的差异,并采用多因素logistic回归模型分析评估颈部淋巴结转移的独立预测因素。本研究共纳入304例患者,其中男性89例,女性215例,年龄5 - 21岁(中位年龄19岁)。不同TgAb和TPOAb状态组间比较显示,性别、术前甲状腺球蛋白(Tg)水平、原发肿瘤位置、原发肿瘤数量及最大肿瘤直径差异均有统计学意义(均P<0.05),提示TgAb组(n = 81)和TPOAb组(n = 84)原发肿瘤特征相对较好。TgAb和TPOAb阳性患者女性更为常见,术前Tg水平大多在正常范围内,TgAb阳性组与TgAb阴性组(223例)在原发肿瘤位置、原发肿瘤数量及最大肿瘤直径方面差异均有统计学意义(均P<0.05)。TPOAb阳性组与TPOAb阴性组(220例)最大肿瘤直径差异有统计学意义(P<0.05)。颈部淋巴结转移危险因素分析显示,中央区淋巴结转移的独立危险因素为最大肿瘤直径>2 cm(OR = 2.84,95%CI:1.59 - 5.07,P<0.001)和甲状腺外侵犯(OR = 0.32,95%CI:0.17 - 0.60,P<0.001),颈侧区淋巴结转移的独立危险因素包括年龄≤14岁(OR = 0.34,95%CI:0.18 - 0.67,P = 0.002)、术前Tg升高(OR = 2.16,95%CI:1.10 - 4.24,P = 0.026)和最大肿瘤直径>2 cm(OR = 3.99,95%CI:2.33 - 6.82,P<0.001)。建议对儿童及青少年PTC患者术前常规检测血清TgAb和TPOAb。术前Tg升高、年龄≤14岁、最大肿瘤直径>2 cm及甲状腺外侵犯是颈部淋巴结转移的危险因素。

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