疑似自身免疫性甲状腺疾病中甲状腺抗体与细胞学特征的相关性

Correlation of thyroid antibodies and cytologic features in suspected autoimmune thyroid disease.

作者信息

Baker B A, Gharib H, Markowitz H

出版信息

Am J Med. 1983 Jun;74(6):941-4. doi: 10.1016/0002-9343(83)90786-6.

Abstract

Six hundred forty-three patients with antithyroid antibody results were studied. Antithyroglobulin antibodies were found in 101, and antimicrosomal antibodies were found in 338 patients. Fine-needle aspiration biopsy, performed in 122 patients, yielded a satisfactory aspirate in 108 subjects. Significant antithyroglobulin and antimicrosomal antibody titers were found in 28 of 57 and 149 of 267 patients, respectively. In 65 patients with cytologically proved Hashimoto's thyroiditis, only 15 had positive antithyroglobulin antibody results (11 titers were 1:1,600 or higher), whereas 61 had positive antimicrosomal antibody results (50 titers were 1:1,600 or higher). Thus, cytologic diagnosis of Hashimoto's thyroiditis correlated better with antimicrosomal antibodies than with antithyroglobulin antibody titers. These data suggest that antithyroglobulin antibody determination offers no particular advantage over antimicrosomal antibody titers. In subjects with a clinical diagnosis of Hashimoto's thyroiditis and negative antibody results, fine-needle aspiration biopsy remains useful in establishing the diagnosis.

摘要

对643例有抗甲状腺抗体检测结果的患者进行了研究。101例患者检测到抗甲状腺球蛋白抗体，338例患者检测到抗微粒体抗体。122例患者接受了细针穿刺活检，其中108例获得了满意的穿刺样本。57例患者中有28例抗甲状腺球蛋白抗体滴度显著升高，267例患者中有149例抗微粒体抗体滴度显著升高。在65例经细胞学证实为桥本甲状腺炎的患者中，只有15例抗甲状腺球蛋白抗体检测结果呈阳性（11例滴度为1:1600或更高），而61例抗微粒体抗体检测结果呈阳性（50例滴度为1:1600或更高）。因此，桥本甲状腺炎的细胞学诊断与抗微粒体抗体的相关性优于抗甲状腺球蛋白抗体滴度。这些数据表明，抗甲状腺球蛋白抗体检测相对于抗微粒体抗体滴度并无特殊优势。对于临床诊断为桥本甲状腺炎但抗体检测结果为阴性的患者，细针穿刺活检在确诊方面仍有帮助。