高级检索

降钙素原测定在甲状腺疾病中的应用

Application of procalcitonin detection in thyroid diseases

    摘要
  • 摘要:
      目的  探讨降钙素原(PCT)在诊断和鉴别诊断甲状腺髓样癌中的价值。
      方法  选取277例甲状腺结节患者为研究对象，均经超声引导下细针穿刺活检确诊，其中良性结节142例，甲状腺髓样癌24例，非甲状腺髓样癌111例(乳头状癌61例，甲状腺滤泡癌30例，未分化癌20例)。所有患者均采用发光法检测降钙素(CT)、癌胚抗原(CEA)、促甲状腺激素(TSH)、PCT。
      结果  良性结节、非甲状腺髓样癌、甲状腺髓样癌患者CT水平呈升高趋势，差异均有统计学意义(P < 0.05或P < 0.01)。PCT在甲状腺髓样癌、良性结节、非甲状腺髓样癌患者中的水平依次为(3.10±2.87)、(0.20±0.19)、(0.14±0.10) μg/L, 其中甲状腺髓样癌患者PCT高于良性结节、非甲状腺髓样癌患者，差异有统计学意义(P < 0.01)。PCT在甲状腺乳头状癌、甲状腺滤泡癌、甲状腺未分化癌患者中的水平依次为(0.18±0.12)、(0.07±0.04)、(0.13±0.01) μg/L, 甲状腺髓样癌患者PCT高于甲状腺乳头状癌、甲状腺滤泡癌、甲状腺未分化癌患者，差异有统计学意义(P < 0.01)。PCT对甲状腺髓样癌诊断的曲线下面积(AUC)为0.978, 95%CI为0.959~0.997, P < 0.001, 当cut-off值取1.58 μg/L时，敏感性和特异性分别为99.00%、98.78%。PCT水平诊断非甲状腺髓样癌的AUC为0.990(95%CI: 0.990~1.000, P < 0.001), 当cut-off值取1.66 μg/L时, PCT对甲状腺髓样癌的诊断敏感性和特异性分别为99.10%、99.90%。
      结论  甲状腺结节患者筛查甲状腺髓样癌时, PCT是一个特异性较好的指标，可以作为CT补充或替代的血清标志物，在非甲状腺髓样癌患者中, PCT也可作为鉴别甲状腺髓样癌的有效指标。

     

    Abstract:
      Objective  To explore value of procalcitonin (PCT) in diagnosis and differential diagnosis of medullary thyroid carcinoma.
      Methods  A tatal of 277 patients with thyroid nodules diagnosed by ultrasound-guided fine needle aspiration biopsy were selected, including 142 cases of benign nodules, 24 cases of medullary thyroid carcinoma, and 111 cases of non-medullary thyroid carcinoma (61 cases of papillary carcinoma, 30 cases of thyroid follicular carcinoma and 20 cases of undifferentiated carcinoma). Calcitonin (CT), carcinoembryonic antigen (CEA), thyroid stimulating hormone (TSH) and PCT were detected by luminescence method in all the patients.
      Results  The CT level in patients with benign nodules, non-medullary thyroid carcinoma and medullary thyroid carcinoma showed a rising trend, and the differences were statistically significant (P < 0.05 or P < 0.01). The levels of PCT in patients with medullary thyroid carcinoma, benign nodules and non-medullary thyroid carcinoma were (3.10±2.87), (0.20±0.19) and (0.14±0.10) μg/L respectively, and PCT level in patients with medullary thyroid carcinoma was significantly higher than that in patients with benign nodules and non-medullary thyroid carcinoma (P < 0.01). The levels of PCT in patients with thyroid papillary carcinoma, thyroid follicular carcinoma and undifferentiated thyroid carcinoma were (0.18±0.12), (0.07±0.04) and (0.13±0.01) μg/L respectively, and PCT level in patients with medullary thyroid carcinoma was significantly higher than that in patients with papillary thyroid carcinoma, thyroid follicular carcinoma and undifferentiated thyroid carcinoma (P < 0.01). The area under curve (AUC) of PCT in the diagnosis of medullary thyroid carcinoma was 0.978 (95%CI, 0.959 to 0.997) and P value was less than 0.001; when the cut-off value was 1.58 μg/L, the sensitivity and specificity were 99.00% and 98.78%, respectively. The AUC of PCT level in the diagnosis of non-medullary thyroid carcinoma was 0.990 (95%CI, 0.990 to 1.000, P < 0.001); when the cut-off value was 1.66 μg/L, the sensitivity and specificity of PCT in the diagnosis of medullary thyroid carcinoma were 99.10% and 99.90%, respectively.
      Conclusion  When screening medullary thyroid carcinoma in patients with thyroid nodules, PCT is a specific index, which can be used as a supplemented or replaced serum marker to CT. In patients with non-medullary thyroid carcinoma, PCT can also be used as an effective index to distinguish medullary thyroid carcinoma.

     

    • HTML全文
    • 参考文献(17)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回