【摘要】 目的 探讨甲状腺激素检测对分化型甲状腺癌切除术后复发的预测价值。方法 对2017年10月至2022年10月于河南省直第三人民医院进行诊治的200例分化型甲状腺癌患者的临床资料进行回顾性分析。按照所有患者术后半年是否出现复发转移将其进行分组，其中复发转移组120例，未复发转移组80例。对2组患者基线资料进行统计，并检测血清刺激性甲状腺球蛋白（ps-Tg）水平。将复发转移组和未复发转移组患者基线资料进行对比；将2组患者中基线资料中差异有统计学意义的因素进行筛选，得出分化型甲状腺癌切除术后复发转移的危险因素；采用受试者工作特征（ROC）曲线分析血清ps-Tg水平对分化型甲状腺癌切除术后复发转移的预测价值。结果 200例患者经过半年的随访发现，有120例患者出现复发转移，占比60.0%，其中有37例复发，占18.5%，转移75例，占37.5%，而复发和转移的患者8例，占4.0%；复发转移组患者中Ⅲ～Ⅳ期、病灶数量>1个的患者占比，以及血清ps-Tg水平相较于未复发转移升高（均P<0.05）;TNM分期为Ⅲ～Ⅳ期、病灶数量>1个、血清ps-Tg水平高为分化型甲状腺癌切除术后复发转移的危险因素（OR=1.161、1.445、1.853，均P<0.05）;ROC曲线结果显示，血清ps-Tg水平预测分化型甲状腺癌切除术后复发转移的曲线下面积为0.907,95%CI值=（0.830,0.957），约登指数为0.779，最佳截断值为149.05 ng/ml，敏感度为80.77%，特异度为97.11%。结论 NM分期为Ⅲ～Ⅳ期、病灶数量>1、血清ps-Tg水平高为分化型甲状腺癌切除术后复发转移的危险因素，血清ps-Tg水平用于分化型甲状腺癌切除术后复发转移的预测中，具有重要的临床价值。更多还原

【Abstract】 Objective To explore the predictive value of thyroid hormone detection on recurrence after resection of differentiated thyroid cancer. Methods The clinical data of 200 patients with differentiated thyroid cancer who were diagnosed and treated at the Third People′ s Hospital of Henan Province from October 2017 to October 2022 were retrospectively analyzed. All patients were grouped according to whether they had recurrent metastasis six months after surgery, including 120 cases in the recurrent metastasis group and 80 cases in the non-recurrent metastasis group. The baseline data of patients in the 2 groups were counted, and the serum stimulated thyroglobulin(ps-Tg) level was detected. The baseline data of patients in the recurrent metastasis group and the non-recurrent metastasis group were compared; factors with statistically significant differences in the baseline data of the 2 groups were screened to derive the risk factors for recurrent metastasis after resection of differentiated thyroid cancer; and the predictive value of serum ps-Tg level for recurrent metastasis after resection of differentiated thyroid cancer was analyzed by using the subject operating characteristic(ROC) curve. Results After six months of follow-up of 200 patients, 120 patients were found to have recurrent metastasis, accounting for60.0%, of which 37 had recurrence, accounting for 18.5%, and 75 cases had metastasis, accounting for 37.5%,whereas there were 8 patients with recurrence and metastasis, accounting for 4.0%; the percentage of patients with stage Ⅲ～Ⅳ and number of lesions > 1 in the patients of the recurrent metastasis group, as well as the serum ps-Tg levels were elevated compared with non-recurrent metastasis(all P<0.05); TNM stage Ⅲ～Ⅳ, number of lesions>1, and high serum ps-Tg levels were risk factors for recurrent metastasis after resection of differentiated thyroid cancer(OR =1.161, 1.445, and 1.853, all P <0.05); and the results of the ROC curves showed that serum ps-Tg levels predicted recurrent metastasis after differentiated thyroid cancer The area under the curve for recurrent metastasis after resection was 0.907, with a 95%CI value of 0.830, 0.957, a Yoden′s index of 0.779, and an optimal cutoff value of 149.05 ng/ml, with a sensitivity of 80.77% and a specificity of 97.11%. Conclusion NM stage Ⅲ～Ⅳ, number of lesions >1, and high serum ps-Tg level are risk factors for recurrent metastasis after resection of differentiated thyroid cancer, and serum ps-Tg level is of significant clinical value in the prediction of recurrent metastasis after resection of differentiated thyroid cancer.更多还原