甲状腺超声联合血清Tg、TgAb对甲状腺癌术后复发诊断中的作用

doi:10.3969/j.issn.1007-3205.2022.04.017

河北医科大学学报 ›› 2022, Vol. 43 ›› Issue (4): 455-459,465.doi: 10.3969/j.issn.1007-3205.2022.04.017

甲状腺超声联合血清Tg、TgAb对甲状腺癌术后复发诊断中的作用

北京市第二医院医学影像科，北京 100031

出版日期:2022-04-25 发布日期:2022-04-30
作者简介:张雪鹤（1986-），女，北京人，北京市第二医院医师，医学硕士，从事腹部及浅表、心血管超声诊断研究。
基金资助:
北京市卫生科技发展专项基金（2019-1-288）

The role of thyroid ultrasound combined with serum Tg and TgAb in the diagnosis of postoperative recurrence of thyroid cancer

Department of Imaging, the Second Hospital of Beijing City, Beijing 100031, China

Online:2022-04-25 Published:2022-04-30

摘要/Abstract

摘要：

目的探讨甲状腺超声联合血清甲状腺球蛋白(thyroglobulin，Tg)、抗甲状腺球蛋白抗体(thyroglobulin antibody，TgAb)对甲状腺癌(thyroid carcinoma，TC)术后复发或转移诊断中的作用。

方法选取我院收治的接受手术切除和131I清除后，需再次接受131I清除的分化型甲状腺癌(differentiated thyroid carcinoma，DTC)患者192例为研究对象，行甲状腺超声检查和血清Tg、TgAb水平检测，再次131I清除治疗1周后行131I全身单光子发射断层成像仪(single photon emission computed tomography，SPECT)显像，记录超声和Tg水平与全身显像(whole body scan,WBS)对照结果，分析TgAb水平对Tg对DTC术后复发或转移灶诊断的影响，并使用二元Logistic回归分析超声和Tg阳性与WBS结果的相关性。

结果超声、Tg及两者联合对DTC术后复发或转移灶的诊断准确度、特异度、敏感度为75.00%、58.33%、78.85%；75.00%、66.67%、76.92%；92.11%、71.43%、96.77%；TgAb≥100 U/mL与＜100 U/mL时，Tg对DTC术后复发或转移灶的诊断效率分别为52.17%、50.00%、52.38%和87.80%、70.00%、93.55%；二元Logistic回归分析显示，超声、Tg阳性患者WBS阳性风险为阴性患者5.218、6.667倍。

结论甲状腺超声联合血清Tg、TgAb检测可有效提升DTC术后复发或转移诊断效率，综合多项指标进行判断，必要情况时进行131I-WBS检查，降低漏诊率。

关键词: 甲状腺肿瘤 , 甲状腺球蛋白, 复发转移

Abstract:

Objective To explore the role of thyroid ultrasound combined with serum thyroglobulin(Tg) and anti-thyroglobulin antibody(TgAb) in the diagnosis of postoperative recurrence or metastasis of thyroid cancer(TC).

Methods In total, 192 patients with differentiated thyroid carcinoma(DTC) who needed to be retreated with 131I clearanceafter treatment with surgical resection and 131I clearance in our hospital were selected as the research subjects. Thyroid ultrasonography was performed and serumTg and TgAb levels were detected. 131I whole-body single photon emission computed tomography(SPECT) imaging was performed at 1 week after retreatment with 131I clearance. The results of ultrasound and Tg levels compared with whole body scan(WBS) were recorded. The effects of TgAb levels and Tg on the diagnosis of recurrence or metastasis after DTC were analyzed, and binary Logistic regression analysis was used to analyze the correlation of ultrasound and positive Tg with WBS results.

Results The accuracy, specificity and sensitivity of ultrasound, Tg and the combination of the two in the diagnosis of recurrence or metastasis after DTC were 75.00%, 58.33%, 78.85%; 75.00%, 66.67%, 76.92%; 92.11%, 71.43%, 96.77 %, respectively. When TgAb≥100 U/mL and ＜100 U/mL, the diagnostic efficiency of Tg for recurrence or metastasis after DTC was 52.17%, 50.00%, 52.38% and 87.80%, 70.00%, 93.55%, respectively.Binary Logistic regression analysis showed that the risk of positive WBS in ultrasound and Tg-positive patients was 5.218 and 6.667 times that of negative patients.

Conclusion Thyroid ultrasound combined with serum Tg and TgAb detection can effectively improve the diagnosis efficiency of recurrence or metastasis after DTC. Comprehensive multiple indicators can be used for judgement, and 131I-WBS examination should be performed, when necessary, to reduce the rate of missed diagnosis.

Key words: thyroid neoplasms, thyroglobulin, recurrence and metastasis

张雪鹤. 甲状腺超声联合血清Tg、TgAb对甲状腺癌术后复发诊断中的作用[J]. 河北医科大学学报, 2022, 43(4): 455-459,465.

ZHANG Xue-he. The role of thyroid ultrasound combined with serum Tg and TgAb in the diagnosis of postoperative recurrence of thyroid cancer[J]. Journal of Hebei Medical University, 2022, 43(4): 455-459,465.

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甲状腺超声联合血清Tg、TgAb对甲状腺癌术后复发诊断中的作用

The role of thyroid ultrasound combined with serum Tg and TgAb in the diagnosis of postoperative recurrence of thyroid cancer

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