Prognostic significance of changes in serum thyroglobulin antibody levels of pre- and post-total thyroidectomy in thyroglobulin antibody-positive papillary thyroid carcinoma patients.
Prognostic significance of changes in serum thyroglobulin antibody levels of pre- and post-total thyroidectomy in thyroglobulin antibody-positive papillary thyroid carcinoma patients.
复制标题
DOI：
10.1507/endocrj.ej12-0410
复制
发表时间：
2013-07
影响因子：
2
通讯作者：
Y. Tsushima;A. Miyauchi;Yasuhiro Ito;Takumi Kudo;H. Masuoka;T. Yabuta;M. Fukushima;M. Kihara;T. Higashiyama;Y. Takamura;Kaoru Kobayashi;A. Miya;T. Kikumori;T. Imai;T. Kiuchi
中科院分区：
文献类型：
--
作者：
Y. Tsushima;A. Miyauchi;Yasuhiro Ito;Takumi Kudo;H. Masuoka;T. Yabuta;M. Fukushima;M. Kihara;T. Higashiyama;Y. Takamura;Kaoru Kobayashi;A. Miya;T. Kikumori;T. Imai;T. Kiuchi
虽然术后血清甲状腺球蛋白（Tg）是甲状腺乳头状癌（PTC）的一个预后指标，但Tg抗体（TgAb）阳性时，它是不可靠的。我们评估了TgAb阳性PTC患者甲状腺全切除术前后血清TgAb水平变化的预后意义。我们回顾了225例TgAb阳性PTC患者的病历，这些患者在2002年4月至2007年3月进行甲状腺全切除术前和术后1-2年测量TgAb水平。我们根据TgAb水平的变化将其分为3组。术后血清TgAb水平降低≥ 50%的患者有181例（80.4%）（第1组），<50%的患者有22例（9.8%）（第2组），升高的患者有22例（9.8%）（第3组）。随访期间，3例患者死于该病，14例患者复发。所有3例死于PTC的患者仅见于第2组和第3组。第2组和第3组显示出相似的预后结果，因此作为第2+3组一起分析。第1组的无淋巴结复发生存率和无远处复发生存率明显优于第2+3组（5年时分别为96.9% vs. 90.5%，p <0.001和98.9% vs. 90.1%，p = 0.004）。预后因素的多因素分析显示，2+3组是预后不良的最强指标。目前的结果表明，甲状腺全切除术后TgAb水平的变化可以是PTC患者的一个重要的动态预后因素。TgAb的前瞻性定期测量是必要的，以确认这些结果。
Although postoperative serum thyroglobulin (Tg) is a prognostic indicator for papillary thyroid carcinoma (PTC), it is unreliable when Tg antibody (TgAb) is positive. We evaluated the prognostic significance of changes in serum TgAb levels of pre- and post-total thyroidectomy in TgAb-positive PTC patients. We reviewed our medical charts of 225 TgAb-positive PTC patients in whom TgAb levels were measured before and 1-2 years after total thyroidectomy, performed between April 2002 and March 2007. We divided them into 3 groups based on changes in TgAb levels. Postoperative serum TgAb levels decreased by ≥ 50% in 181 patients (80.4%) (Group 1), by <50% in 22 patients (9.8%) (Group 2), and increased in 22 patients (9.8%) (Group 3). During the follow-up, 3 patients died of the disease and 14 patients had recurrences. All 3 patients who died of PTC were seen only in Groups 2 and 3. Groups 2 and 3 showed similar prognostic outcomes, thus were analyzed together as Group 2+3. Group 1 had significantly better lymph node recurrence-free survival and distant recurrence-free survival than Group 2+3 (96.9% vs. 90.5%, p <0.001, and 98.9% vs. 90.1%, p = 0.004, respectively at 5 years). Multivariate analyses on prognostic factors revealed that classification to Group 2+3 was the strongest indicator for poor prognosis. The present results suggest that changes in TgAb levels following total thyroidectomy can be an important dynamic prognostic factor of PTC patients. Prospective periodical measurements of TgAb are necessary to confirm these findings.