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目的探讨术前测定血清甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)在甲状腺冷结节评估中的临床意义。方法甲状腺冷结节患者85例分为桥本病(HD)伴良性结节组(A组,7例)、HD合并恶性组(B组,7例)、甲状腺癌组(C组,19例)、结节性甲状腺肿组(D组,44例)和甲状腺腺瘤组(E组,8例)。回顾性分析5组患者血清TGAb、TPOAb水平差异;比较TGAb、TPOAb双阳性冷结节与TGAb、TPOAb双阴性冷结节恶性发生率的差异。结果 A、B组TGAb、TPOAb测定值及阳性率均显著高于其余三组(P<0.05)。C组TGAb阳性率42.10%,显著高于D组的11.36%(P<0.05)。TGAb、TPOAb双阳性冷结节恶性发生率50%,显著高于TGAb、TPOAb双阴性冷结节者的20.75%(P<0.05)。结论 TGAb、TPOAb水平增高最常见于HD;TGAb、TPOAb双阳性冷结节较TGAb、TPOAb双阴性冷结节有更高的恶性风险。
Objective To investigate the clinical significance of preoperative determination of serum thyroglobulin antibody (TGAb) and thyroid peroxidase antibody (TPOAb) in the evaluation of thyroid cold nodules. Methods Eighty-five patients with thyroid cold nodules were divided into Hashimoto’s disease (HD) with benign nodules (group A, n = 7), HD with malignancy (group B, n = 7), thyroid cancer ), Nodular goiter (group D, 44 cases) and thyroid adenoma (group E, 8 cases). The differences of serum TGAb and TPOAb levels in 5 groups of patients were retrospectively analyzed. The difference of the malignant rates between TGAb, TPOAb double positive cold nodules and TGAb, TPOAb double negative cold nodules was compared. Results The values of TGAb and TPOAb in group A and group B were significantly higher than those in the other three groups (P <0.05). The positive rate of TGAb in group C was 42.10%, which was significantly higher than that in group D (11.36%, P <0.05). TGAb, TPOAb double cold positive nodules 50%, significantly higher than TGAb, TPOAb double negative cold nodules 20.75% (P <0.05). Conclusions The increased levels of TGAb and TPOAb are most common in HD. TGAb and TPOAb double positive cold nodules have a higher malignant risk than TGAb and TPOAb double negative cold nodules.