| 血清TK1，TSH，TG，TGAb 检测联合TI RADS 分类在甲状腺乳头状癌早期筛查中的应用价值 |
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| 引用本文： | 宋晓龙,宋 宇,魏 龙,周建平.血清TK1，TSH，TG，TGAb 检测联合TI RADS 分类在甲状腺乳头状癌早期筛查中的应用价值[J].现代检验医学杂志,2022,0(4):38-42. |
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| 作者姓名： | 宋晓龙 宋 宇 魏 龙 周建平 |
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| 作者单位： | 陕西省人民医院放射免疫中心，西安 710068 |
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| 摘 要： | 目的 探讨血清胸苷激酶1（thymidine kinase 1,TK1）、促甲状腺激素（thyroid stimulating hormone,TSH）、甲状腺球蛋白（thyroglobulin,TG）和甲状腺球蛋白抗体（thyroglobulin antibodies，TGAb）单独检测及联合甲状腺影像报告和数据系统（thyroid imaging reporting and data system，TI-RADS）分类在甲状腺乳头状癌（papillary thyroid cancinoma,PTC）早期筛查中的应用价值。方法 选取2021 年1 ～ 10 月于陕西省人民医院首诊的176 例甲状腺结节患者，其中甲状腺乳头状癌116 例、甲状腺良性结节（benign thyroid nodules,BTN）60 例，同期选择60 例健康体检人员为健康对照组（healthy control,HC）。应用单因素方差分析比较组间血清TK1，TSH，TG 和TGAb 的浓度差异，采用卡方检验分析甲状腺超声结果的差异，通过受试者工作特征曲线（receiver operating characteristic curve,ROC）及Logistic 回归分析评估各指标单独及联合检测在PTC 早期筛查中的诊断效能。结果 PTC 组血清TK1（1.61±0.66pmol/L），TSH（3.18±1.84uIU/ml），TG（158.61±126.77ng/ml）水平较BTN 组及HC 组明显增高（0.72±0.28pmol/L，2.22±1.90uIU/ml，93.31±69.57ng/ml；0.32±0.25pmol/L，2.43±0.97uIU/ml，10.72±7.19ng/ml），差异有统计学意义（F = 53.65，3.29,23.38，均P ＜ 0.05）。PTC 组患者结节质地实性、低回声、边界不清、微钙化、纵横比＞ 1 及TIRADS 分类（≥ 4 类）比例高于BTN 组，差异有统计学意义（χ2=4.68 ～ 48.68，均P ＜ 0.05）；血清TK1，TSH 和TG 检测联合TI-RADS 分类诊断PTC 的灵敏度和特异度分别为89.7% 和80.0%，曲线下面积（area under the curve, AUC）为0.914 ＞ AUCTK1（0.827）＞ AUCTI-RADS（0.794）＞ AUCTG（0.664）＞ AUCTSH（0.661）。结论 血清TK1，TSH 和TG 检测联合甲状腺超声TIRADS分类可提高甲状腺结节良恶性鉴别诊断效能，在PTC 早期筛查中具有重要的临床应用价值。
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| 关 键 词： | 胸苷激酶1 甲状腺影像报告和数据系统（TI-RADS）分类 甲状腺乳头状癌 鉴别诊断 |
Clinical Value of Serum TK1, TSH,TG and TGAb Detection Combined with TI-RADS Classification in Papillary Thyroid Carcinoma |
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| SONG Xiao-long,SONG Yu,WEI Long,ZHOU Jian-ping.Clinical Value of Serum TK1, TSH,TG and TGAb Detection Combined with TI-RADS Classification in Papillary Thyroid Carcinoma[J].Journal of Modern Laboratory Medicine,2022,0(4):38-42. |
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| Authors: | SONG Xiao-long SONG Yu WEI Long ZHOU Jian-ping |
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| Affiliation: | Radioimmunoassay Center, Shaanxi Provincial People’s Hospital, Xi’an 710068，China |
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| Abstract: | Objective To investigate the value in the individual and combined tests of serum thymidine kinase 1 (TK1)，thyroid stimulating hormone (TSH)，thyroglobulin(TG)，thyroglobulin antibodies（TGAb）and thyroid imaging reporting and data system（TI-RADS）classification in the early screening of papillary thyroid carcinoma. Methods A total of 176 patients diagnosed in Shaanxi Provincial People’s Hospital from January to October 2021 were selected，including 116 cases of papillary thyroid carcinoma (PTC ) and 60 cases of benign thyroid nodules (BTN). In the same period, 60 health controls(HC) were selected. The ANOVA was used to compare the differences in serum TK1,TSH,TG and TGAb between groups, the chi-square test was used to analyze the differences in thyroid ultrasound results, the receiver operating characteristic curve(ROC)and Logistic regression analysis were used to evaluate the diagnostic value of individual and combined monitoring of various indicators in the early screening of PTC. Results The levels of serum TK1（1.61±0.66pmol/L）, TSH（3.18±1.84uIU/ml）and TG （158.61±126.77ng/ml） in PTC group were significantly higher than those in BTN and HC groups（0.72±0.28pmol/L， 2.22±1.90uIU/ml，93.31±69.57ng/ml；0.32±0.25pmol/L，2.43±0.97uIU/ml，10.72±7.19ng/ml）, and the differences were statistically significant （F = 536.65，3.29, 23.38，all P ＜ 0.05）.The proportion of patients whose nodules were solidtexture，hypoechoic，irregular edges，microcalcification,aspect ratio >1and TI-RADS classification( ≥ 4) in PTC group were significantly higher than those in BTN group（χ2=4.68 ～ 48.68，all P ＜ 0.05）.While serum TK1, TSH and TG detection combined with TI-RADS classification diagnosed PTC,the sensitivity and the specificity were 89.7% and 80.0% respectivel, and the area under the curve(AUC) was 0.914 ＞ AUCTK1 (0.827) ＞ AUCTI-RADS(0.794) ＞ AUCTG (0.664) ＞ AUCTSH(0.661). Conclusion The combined detection of serum TK1, TSH, TG and TI-RADS classification can improve the diagnostic efficiency for thyroid nodules, and has important clinical application value in the early screening of PTC. |
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