| 陈鹏,宋长祥,陆武,刘永,杜鹏.分化型甲状腺癌术后首次131I治疗前刺激性甲状腺球蛋白水平预测肿瘤转移[J].中国医学影像技术,2016,32(12):1862~1865 |
| 分化型甲状腺癌术后首次131I治疗前刺激性甲状腺球蛋白水平预测肿瘤转移 |
| Stimulated thyroglobulin in predicting metastasis of postoperative patients with differentiated thyroid carcinoma before first 131I ablation therapy |
| 投稿时间：2016-05-12 修订日期：2016-08-12 |
| DOI：10.13929/j.1003-3289.2016.12.018 |
| 中文关键词: 甲状腺肿瘤 甲状腺球蛋白 放射治疗 |
| 英文关键词:Thyroid neoplasms Thyroglobulin Radioiodine therapy |
| 基金项目: |
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| 摘要点击次数: 2435 |
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| 中文摘要: |
| 目的 探讨分化型甲状腺癌（DTC）术后首次131I治疗前测定的刺激性甲状腺球蛋白（sTg）水平预测转移的价值。方法 对101例行甲状腺全切术及颈淋巴结清扫术的DTC患者，于首次131I治疗前1天测定sTg水平，131I治疗后5~7天行131I-SPECT/CT显像。根据是否存在转移，将所有患者分为无转移（M0）组和有转移（M1）组。采用Mann-Whitney秩和检验比较两组间sTg水平，并通过ROC曲线及最佳诊断界值点（DCP）评估sTg预测DTC转移的价值；采用Kappa检验对sTg诊断结果与临床最终诊断结果行一致性检验。结果 M1组的sTg水平高于M0组，差异有统计学意义（U=328.00，P<0.001）。sTg的ROC曲线下面积为0.870，最佳DCP为40.60 ng/ml，灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为72.34%（34/47）、100%（54/54）、87.13%（88/101）、100%（34/34）、80.60%（54/67）；sTg值诊断DTC转移与临床最终诊断结果一致性良好（Kappa=0.737，P<0.05）。结论 首次131I治疗前检测sTg可作为有效预测DTC转移的指标，可指导131I的治疗剂量。 |
| 英文摘要: |
| Objective To investigate the value of stimulated thyroglobulin (sTg) in predicting metastasis in postoperative patients with differentiated thyroid carcinoma (DTC) before the first time 131I ablation therapy. Methods Totally 101 patients with DTC who underwent total thyroidectomy and lymphadenectomy were included. The pre-ablation sTg level of 101 patients was measured one day before first 131I ablation therapy, and the patients underwent 131I-SPECT/CT on 5-7 days after 131I ablation therapy. All patients were divided into M0 group and M1 group according to the presence and absence of metastases, respectively. The sTg value between the 2 groups was compared by Mann-Whitney rank-sun test. The ROC curve and diagnostic critical point (DCP) were analyzed to evaluate the predictive value of sTg, and the consistency of the results in DCP and clinical final diagnosis results was analyzed with Kappa test. Results The pre-ablation sTg of M1 group were significantly higher than that of M0 group (U=328.00, P<0.001). Area under the ROC curve for sTg levels was 0.870, the DCP of sTg was 40.60 ng/ml with the sensitivity of 72.34% (34/47), specificity of 100% (54/54), accuracy of 87.13% (88/101), positive predictive value of 100% (34/34), and negative predictive value of 80.60% (54/67). The consistency of the results in DCP and clinical final diagnosis results was good (Kappa=0.737, P<0.05). Conclusion The pre-ablation sTg is a useful diagnostic marker for predicting metastases before the first 131I ablation therapy, which can guide the dose of 131I ablation therapy. |
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