摘要
目的 探讨甲状腺切除术后抗甲状腺球蛋白抗体(TgAb)水平对术前甲状腺球蛋白阴性的分化型甲状腺癌(DTC)患者预后的预测价值。方法 收集82例术前甲状腺球蛋白阴性的DTC患者的临床资料,根据术后1年TgAb水平将患者分为转阴组(n=35)和未转阴组(n=47)。比较两组患者的临床病理特点及不同TgAb水平患者的术后复发率,分析DTC患者预后的影响因素。结果 与转阴组比较,未转阴组男性、临床分期为Ⅲ~Ⅳ期、淋巴结转移及侵犯包膜的比例更大(均P<0.05)。术后1年,TgAb水平升高者的复发率高于TgAb转阴者和TgAb水平降低>50%者(均P<0.05)。临床分期、淋巴转移是DTC患者术后复发的独立危险因素,TgAb转阴是DTC患者术后复发的保护因素(均P<0.05)。结论 甲状腺切除术后TgAb水平的变化趋势有助于预测术前甲状腺球蛋白阴性的DTC患者的复发风险,TgAb转阴者可表现出更好的预后。
Objective To explore the predictive value of post-thyroidectomy thyroglobulin antibody(TgAb)level for prognosis in preoperative thyroglobulin-negative patients with differentiated thyroid cancer(DTC).Methods The clinical data of 82 preoperative thyroglobulin-negative patients with DTC were collected,and the patients were divided into seroclearance group(n=35)and non-seroclearance group(n=47)according to their postoperative 1-year TgAb levels.Clinicopathological characteristics were compared between the two groups,postoperative recurrence rates of patients with different TgAb levels were also compared,and influencing factors of prognosis were analyzed in patients with DTC.Results Compared with the seroclearance group,the non-seroclearance group had higher proportions of male cases,cases of clinical stageⅢ-Ⅳ,cases of lymph node metastasis,and cases suffering capsular invasion(all P<0.05).One year after operation,patients with elevated TgAb level obtained a higher recurrence rate as compared to patients with TgAb seroclearance or with a>50%decrease in TgAb level(all P<0.05).Clinical stage and lymphatic metastasis were independent risk factors for postoperative recurrence in patients with DTC,and TgAb seroclearance was a protective factor for postoperative recurrence in patients with DTC(all P<0.05).Conclusion Understanding the variance tendency of TgAb level after thyroidectomy might contribute to predicting the recurrence risk of preoperative thyroglobulin-negative patients with DIC,and those with TgAb seroclearance might present better prognosis.
作者
陈勇
徐宙
CHEN Yong;XU Zhou(Department of General Surgery,Baoshan Hospital of Integrated TraditionalChinese and Western Medicine of Shanghai City,Shanghai 201900,China)
出处
《广西医学》
CAS
2019年第10期1251-1254,共4页
Guangxi Medical Journal
