术前血清甲状腺球蛋白检测对甲状腺乳头状癌颈部淋巴结转移的预测价值分析

doi:10.11904/j.issn.1002-3070.2023.01.009

实用肿瘤学杂志 ›› 2023, Vol. 37 ›› Issue (1): 52-57.doi: 10.11904/j.issn.1002-3070.2023.01.009

术前血清甲状腺球蛋白检测对甲状腺乳头状癌颈部淋巴结转移的预测价值分析

王依莹¹, 孔伟², 刘庆华³, 邢浩⁴, 尹峰燕⁴, 刘新悦¹, 何倩¹, 邢薇佳¹

1.山东第一医科大学公共卫生与健康管理学院(济南 250000);
2.山东第一医科大学第二附属医院甲状腺外科;
3.山东第一医科大学第二附属医院检验医学科;
4.泰安市中心医院甲状腺外科

收稿日期:2022-11-25 修回日期:2023-01-13 出版日期:2023-02-28 发布日期:2023-03-21
通讯作者: 邢薇佳,E-mail:wjxing@sdfmu.edu.cn
作者简介:王依莹,女,(1997-),硕士研究生,从事甲状腺恶性肿瘤的病因机制研究。
基金资助:
山东省医药卫生科技发展计划项目(编号:202012050653)

Analysis for predictive value of preoperative serum thyroglobulin detection in cervical lymph node metastasis of thyroid papillary carcinoma

WANG Yiying¹, KONG Wei², LIU Qinghua³, XING Hao⁴, YIN Fengyan⁴, LIU Xinyue¹, HE Qian¹, XING Weijia¹

1. School of Public Health,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250000,China;
2. Department of Thyroid Surgery,The Second Affiliated Hospital of Shandong First Medical University;
3. Department of Clinical Laboratory,The Second Affiliated Hospital of Shandong First Medical University;
4. Department of Thyroid Surgery,Taian Central Hospital

Received:2022-11-25 Revised:2023-01-13 Online:2023-02-28 Published:2023-03-21

摘要/Abstract

摘要： 目的探讨术前血清甲状腺球蛋白(Preoperative serum thyroglobulin,PS-Tg)与甲状腺乳头状癌(Papillary carcinoma of thyroid,PTC)淋巴结转移(Lymph node metastasis,LNM)的关系。方法本研究纳入2021年10月—2022年10月行甲状腺切除术并经术后病理证实的PTC患者,并收集其临床及病理资料283份。单因素、多因素logistic回归分析PS-Tg与PTC LNM的关系,绘制列线图将两者关系量化,通过ROC曲线确定最佳截断值。结果 PTC合并LNM组PS-Tg水平高于单纯PTC组(P＜0.05),单因素与多因素logistic回归分析发现PS-Tg水平升高可能是PTC发生LNM的独立危险因素,且PS-Tg水平升高可解释约15%的PTC LNM风险。结论 PS-Tg水平升高可能是PTC患者颈部LNM的危险因素,对术前LNM诊断有一定的预测价值。

关键词: 甲状腺乳头状癌, 淋巴结转移, 术前血清甲状腺球蛋白

Abstract: Objective The Objective of this study was to investigate the relationship between preoperative serum thyroglobulin(PS-Tg)and lymph node metastasis(LNM)in papillary thyroid carcinoma(PTC). Methods This study included 283 clinical and pathological data of PTC patients who underwent thyroidectomy from October 2021 to September 2022 and were confirmed by postoperative pathology.The relationship between PS-Tg and PTC LNM was analyzed by univariable and multivariable logistic regression,the nomogram was used to quantify the relationship between them,and the optimal cut-off value was determined by receiver operating characteristic(ROC)curves. Results The level of PS-Tg in the PTC combined with LNM group was higher than that in the pure PTC group(P＜0.05).Univariable and multivariable logistic regression analyses showed that elevated PS-Tg level might be an independent risk factor for LNM of PTC,and the increase of PS-Tg level could explain approximately 15% of the risk of LNM in PTC. Conclusion Elevated PS-Tg level may be a risk factor for cervical LNM in PTC patients,and it has a certain predictive value for preoperative LNM diagnosis.

Key words: Papillary thyroid carcinoma, Lymph node metastasis, Preoperative serum thyroglobulin

中图分类号:

R736.1

王依莹, 孔伟, 刘庆华, 邢浩, 尹峰燕, 刘新悦, 何倩, 邢薇佳. 术前血清甲状腺球蛋白检测对甲状腺乳头状癌颈部淋巴结转移的预测价值分析[J]. 实用肿瘤学杂志, 2023, 37(1): 52-57.

WANG Yiying, KONG Wei, LIU Qinghua, XING Hao, YIN Fengyan, LIU Xinyue, HE Qian, XING Weijia. Analysis for predictive value of preoperative serum thyroglobulin detection in cervical lymph node metastasis of thyroid papillary carcinoma[J]. Journal of Practical Oncology, 2023, 37(1): 52-57.

参考文献

1 Kim J,Gosnell JE,Roman SA.Geographic influences in the global rise of thyroid cancer[J].Nat Rev Endocrinol,2020,16(1):17-29.
2 梁洁,王新华,王健.非远处转移性甲状腺乳头状癌¹³¹I疗效预测模型的分析[J].实用肿瘤学杂志,2022,36(3):220-225.
3 Lundgren CI,Hall P,Dickman PW,et al.Clinically significant prognostic factors for differentiated thyroid carcinoma:A population-based,nested case-control study[J].Cancer,2006,106(3):524-531.
4 Moo TA,McGill J,Allendorf J,et al.Impact of prophylactic central neck lymph node dissection on early recurrence in papillary thyroid carcinoma[J].World J Surg,2010,34(6):1187-1191.
5 Coscia F,Taler-Verˇciˇc A,Chang VT,et al.The structure of human thyroglobulin[J].Nature,2020,578(7796):627-630.
6 Trimboli P,Treglia G,Giovanella L.Preoperative measurement of serum thyroglobulin to predict malignancy in thyroid nodules:A systematic review[J].Horm Metab Res,2015,47(4):247-252.
7 Sakamoto K,Imanishi Y,Tomita T,et al.Usefulness and limitation of thyroglobulin measurement in fine needle aspirates(FNA-Tg)for diagnosis of neck lymph node metastasis from thyroid carcinoma[J].Nihon Jibiinkoka Gakkai Kaiho,2016,119(5):721-726.
8 Frasoldati A,Pesenti M,Gallo M,et al.Diagnosis of neck recurrences in patients with differentiated thyroid carcinoma[J].Cancer,2003,97(1):90-96.
9 Sung H,Ferlay J,Siegel RL,et al.Global cancer statistics 2020:Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2021,71(3):209-249.
10 Arianpoor A,Asadi M,Amini E,et al.Investigating the prevalence of risk factors of papillary thyroid carcinoma recurrence and disease-free survival after thyroidectomy and central neck dissection in iranian patients[J].Acta Chir Belg,2020,120(3):173-178.
11 Malterling RR,Andersson RE,Falkmer S,et al.Differentiated thyroid cancer in a swedish county--long-term results and quality of life[J].Acta Oncol,2010,49(4):454-459.
12 徐志勇,马晓良.甲状腺癌患者术后复发风险预测的列线图模型建立[J].实用肿瘤学杂志,2021,35(1):35-40.
13 Haugen BR,Alexander EK,Bible KC,et al.2015 american thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer:The american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer[J].Thyroid,2016,26(1):1-133.
14 李楠楠.甲状腺球蛋白联合血清CEA鉴别甲状腺良、恶性肿瘤中的应用价值[J].微量元素与健康研究,2022,39(6):16-17.
15 Mao J,Zhang Q,Zhang H,et al.Risk factors for lymph node metastasis in papillary thyroid carcinoma:A systematic review and meta-analysis[J].Front Endocrinol(Lausanne),2020,11:265.
16 Chang Q,Zhang J,Wang Y,et al.Nomogram model based on preoperative serum thyroglobulin and clinical characteristics of papillary thyroid carcinoma to predict cervical lymph node metastasis[J].Front Endocrinol(Lausanne),2022,13:937049.
17 Pacini F,Fugazzola L,Lippi F,et al.Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses:A clue to the diagnosis of metastatic differentiated thyroid cancer[J].J Clin Endocrinol Metab,1992,74(6):1401-1404.
18 柴吉鑫,陈泳,齐艳涛,等.甲状腺球蛋白和抗体定量预测分化型甲状腺癌早期淋巴结转移的列线图模型[J].实用临床医药杂志,2021,25(21):7-11.
19 Wang Y,Liu Y,Wang X,et al.Intraoperative measurement of thyroglobulin in lymph node aspirates for the detection of metastatic papillary thyroid carcinoma[J].Onco Targets Ther,2017,10:4435-4441.
20 Dellal FD,Aydin C,Tam AA,et al.The value of serum thyroglobulin alteration after ultrasonography-guided fine-needle biopsy of suspicious cervical lymph nodes in the diagnosis of metastasis in patients with differentiated thyroid cancer[J].Int J Clin Pract,2021,75(7):e14218.
21 Peiris AN,Medlock D,Gavin M.Thyroglobulin for monitoring for thyroid cancer recurrence[J].JAMA,2019,321(12):1228.
22 Patell R,Mikhael A,Tabet M,et al.Assessing the utility of preoperative serum thyroglobulin in differentiated thyroid cancer:A retrospective cohort study[J].Endocrine,2018,61(3):506-510.
23 Kim H,Park SY,Choe JH,et al.Preoperative serum thyroglobulin and its correlation with the burden and extent of differentiated thyroid cancer[J].Cancers(Basel),2020,12(3):1-10.
24 Kim H,Kim YN,Kim HI,et al.Preoperative serum thyroglobulin predicts initial distant metastasis in patients with differentiated thyroid cancer[J].Sci Rep,2017,7(1):16955.
25 Feng Y,Min Y,Chen H,et al.Construction and validation of a nomogram for predicting cervical lymph node metastasis in classic papillary thyroid carcinoma[J].J Endocrinol Invest,2021,44(10):2203-2211.
26 Feng JW,Hong LZ,Wang F,et al.A nomogram based on clinical and ultrasound characteristics to predict central lymph node metastasis of papillary thyroid carcinoma[J].Front Endocrinol(Lausanne),2021,12:666315.
27 Zhou SC,Liu TT,Zhou J,et al.An ultrasound radiomics nomogram for preoperative prediction of central neck lymph node metastasis in papillary thyroid carcinoma[J].Front Oncol,2020,10:1591.
28 田军军,陶然,沈银峰,等.甲状腺癌患者血清甲状腺球蛋白以及抗甲状腺球蛋白抗体水平与肺转移、骨转移的相关性研究[J].海南医学院学报,2017,23(12):1679-1681.
29 刘安民,王永梅,李玥.分析甲状腺球蛋白(tg)与分化型甲状腺癌转移灶的相关性及tg的诊断意义[J].当代医学,2015,21(36):43-44.

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术前血清甲状腺球蛋白检测对甲状腺乳头状癌颈部淋巴结转移的预测价值分析

Analysis for predictive value of preoperative serum thyroglobulin detection in cervical lymph node metastasis of thyroid papillary carcinoma

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