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甲状腺 1-4cm 大小的乳头状甲状腺癌患者行甲状腺叶切除术后的血清甲状腺球蛋白检测。

Serum thyroglobulin testing after thyroid lobectomy in patients with 1-4 cm papillary thyroid carcinoma.

机构信息

Division of Endocrinology & Metabolism, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.

Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.

出版信息

Endocrine. 2023 Aug;81(2):290-297. doi: 10.1007/s12020-023-03346-2. Epub 2023 Mar 13.

Abstract

BACKGROUND

The role of measuring serum thyroglobulin (Tg) levels in patients who have undergone lobectomy has not been proven. The goal of this research is to see if serum Tg levels can predict the recurrence of papillary thyroid carcinoma (PTC) after lobectomy.

METHODS

The 463 patients with 1-4 cm PTC who underwent lobectomy between January 2005 and December 2012, were included in this retrospective cohort study. Postoperative serum Tg levels and neck ultrasound were evaluated every 6-12 months after lobectomy during a median 7.8-year follow-up period. The receiver operating characteristic (ROC) curve and its area under the ROC curve (AUC) was used to assess the diagnostic performance of serum Tg levels.

RESULTS

During the follow-up, the structural recurrent disease was confirmed in 30 patients (6.5%). The serum Tg levels measured by initial Tg, maximal Tg, and last Tg did not differ statistically between the recurrence and non-recurrence groups. According to our findings, serial patterns of serum maximal Tg variations in 30 patients with recurrence showed no obvious trend and no rising trend toward recurrence before detecting recurrence. The AUC was 54.5% (IQR 43.1%-65.9%) in the ROC curve analysis, indicating that it was not significantly different from the random classifier.

CONCLUSION

Serum Tg levels did not differ significantly between the recurrence and non-recurrence groups, and there was no tendency for the recurrence group to increase Tg levels. In patients with PTC who underwent lobectomy, monitoring Tg levels regularly provides little benefit in predicting recurrence.

摘要

背景

对接受过甲状腺叶切除术的患者测量血清甲状腺球蛋白 (Tg) 水平的作用尚未得到证实。本研究的目的是观察血清 Tg 水平是否可以预测甲状腺乳头状癌 (PTC) 患者甲状腺叶切除术后的复发情况。

方法

回顾性队列研究纳入了 2005 年 1 月至 2012 年 12 月期间接受甲状腺叶切除术的 463 例 1-4cm PTC 患者。在中位随访 7.8 年后,于甲状腺叶切除术后每 6-12 个月评估术后血清 Tg 水平和颈部超声。采用受试者工作特征 (ROC) 曲线及其 ROC 曲线下面积 (AUC) 评估血清 Tg 水平的诊断性能。

结果

在随访期间,30 例患者(6.5%)确认结构性疾病复发。复发组和非复发组之间初始 Tg、最大 Tg 和末次 Tg 测量的血清 Tg 水平无统计学差异。根据我们的发现,30 例复发患者的血清最大 Tg 变化的系列模式在检测到复发之前没有明显的复发趋势,也没有呈上升趋势。ROC 曲线分析的 AUC 为 54.5%(IQR 43.1%-65.9%),表明与随机分类器无显著差异。

结论

复发组和非复发组之间的血清 Tg 水平无显著差异,且复发组 Tg 水平无升高趋势。在接受甲状腺叶切除术的 PTC 患者中,定期监测 Tg 水平对预测复发没有明显益处。

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