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目的探讨术前甲状腺自身抗体[甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb)]的水平与分化型甲状腺癌的关系。方法回顾性分析2006年1月-2016年12月在天津市海河医院首次行甲状腺结节手术的患者773例,术后病理学明确诊断为分化型甲状腺癌(DTC)315例和良性甲状腺结节458例,检测两组患者术前TGAb、TPOAb水平,进行统计学分析。结果 DTC患者TGAb阳性率显著高于良性甲状腺结节患者(21.3%vs14.2%;P<0.05)。DTC患者与良性结节患者TPOAb阳性率比较差异无统计学意义(12.7%vs9.6%;P>0.05)。315例DTC患者中,TGAb阳性患者男性多于女性(P<0.05),TGAb阳性患者侵犯包膜比例(49.3%vs35.1%;P<0.05)以及淋巴结转移比例(41.8%vs28.6%;P<0.05)均高于TGAb阴性组,差异有统计学意义。但在年龄(P>0.05)、肿瘤大小(P>0.05)、癌灶特点(P>0.05)及肿瘤分期III/IV(P>0.05)方面差异无统计学意义。而TPOAb阳性与DTC患者临床病理特征并无相关性。结论术前检测TGAb可能是预测分化型甲状腺癌风险的一个指标,与恶性肿瘤侵及包膜以及淋巴结转移有一定相关性。
Objective To investigate the relationship between preoperative thyroid autoantibodies (thyroglobulin antibody (TGAb), thyroid peroxidase antibody (TPOAb)) and differentiated thyroid cancer. Methods A retrospective analysis of 773 cases of thyroid nodules in Haihe Hospital of Tianjin City from January 2006 to December 2016 was retrospectively performed. Postoperative pathology was diagnosed as 315 cases of differentiated thyroid cancer (DTC) and benign thyroid nodules 458 cases were detected preoperative TGAb, TPOAb levels, for statistical analysis. Results The positive rate of TGAb in patients with DTC was significantly higher than that in patients with benign thyroid nodules (21.3% vs14.2%; P <0.05). There was no significant difference in the positive rate of TPOAb between patients with DTC and benign nodules (12.7% vs 9.6%; P> 0.05). Among 315 DTC patients, TGAb positive patients had more males than females (P <0.05), TGAb positive patients (49.3% vs 35.1%; P <0.05) and lymph node metastasis (41.8% vs 28.6%; P <0.05) were higher than TGAb negative group, the difference was statistically significant. However, there was no significant difference in age (P> 0.05), tumor size (P> 0.05), tumor characteristics (P> 0.05) and tumor stage III / IV (P> 0.05). The TPOAb positive and DTC patients with no clinical and pathological features. Conclusion Preoperative detection of TGAb may be an index for predicting the risk of differentiated thyroid cancer, which may be related to invasion of tumor and lymph node metastasis.