关键词: 分化型甲状腺癌； 甲状腺球蛋白抗体； 促甲状腺素； 临床病理特征； 术后转移

Abstract: Objective To investigate the correlation between serum thyroid globulin antibody (TgAb),thyroid stimulating hormone (TSH) levels and clinical pathological features of differentiated thyroid cancer (DTC) patients,and their predictive value for postoperative metastasis.Methods From June 2022 to June 2023,103 DTC patients treated in our hospital were included as the diseased group.They were separated into a metastasis group (26 cases) and a non metastasis group (77 cases) based on whether they had postoperative metastasis.Another 103 patients with benign thyroid lesions were included as the control group.The levels of TgAb and TSH in serum were compared.Multivariate Logistic regression was applied to analyze the influencing factors of postoperative metastasis in DTC patients.ROC curve was applied to analyze the predictive value of serum TgAb and TSH levels for postoperative metastasis in DTC patients.Results Compared with the control group[(54.65±6.68)IU/ml,(1.24±0.36）mIU/L],the serum TgAb and TSH levels in the cancer group[(110.56±13.42）IU/ml,（5.28±1.73)mIU/L)] were significantly increased (P<0.05).Patients with low differentiation,TNM stage Ⅲ+Ⅳ,and tumor infiltration had obviously higher levels of serum TgAb and TSH than patients with medium to high differentiation,TNM stage Ⅰ+Ⅱ,and no tumor infiltration (P<0.05).Compared with the non metastasis group,the serum TgAb and TSH levels,and the proportions of low differentiation and tumor infiltration were obviously higher in the metastasis group (P<0.05).TgAb and TSH were influencing factors for postoperative metastasis in DTC patients (P<0.05).The area under the curve (AUC) for predicting postoperative metastasis in DTC patients based on serum TgAb and TSH levels was 0.778 and 0.756,respectively,with a combined predicted AUC of 0.889.The AUC predicted by the combination of the two indicators was obviously higher than that predicted by a single indicator (Z_{combination-TgAb}=2.200,Z_{combination-TSH}=1.950,P=0.028,0.046),the sensitivity and specificity of the combined prediction of the two were 76.81% and 94.81%,respectively.Conclusion Serum TgAb and TSH levels in DTC patients are obviously upregulated,and there is a certain correlation between changes in TgAb and TSH levels and clinical pathological features.The combination of the two has high predictive value for postoperative metastasis in patients.

Key words: differentiated thyroid cancer; thyroid globulin antibody; thyroid stimulating hormone; clinical pathological features; postoperative metastasis