胸苷激酶1和甲状腺球蛋白检测对鉴别甲状腺结节良恶性的价值

摘要

目的:探讨血清胸苷激酶1(serum-thymidine kinase 1,S-TK1)和甲状腺球蛋白(thyroglobulin,Tg)联合检测对鉴别甲状腺结节良恶性的价值.方法:选择2015年10月至2017年9月四川省人民医院初治81例甲状腺恶性结节、62例甲状腺良性结节以及40例健康者血清.通过酶免疫点印迹化学发光法检测S-TK1以及化学发光法检测血清Tg的水平,比较二者在各组的差异,应用Logistic回归分析和ROC曲线评价S-TK1和Tg在甲状腺结节良恶性的鉴别价值.结果:甲状腺恶性结节组S-TK1和Tg水平[(5.33±3.38)pmol/L和(61.86±24.80)ng/mL]明显高于良性结节组[(1.40±0.99)pmol/L和(45.13±15.80)ng/mL]及正常对照组[(1.35±0.41)pmol/L和(40.88±15.45)ng/mL](P<0.05).回归模型中的联合检测阳性预测值P与S-TK1、Tg单项检测的ROC曲线分析显示:S-TK1和Tg的Cut-off值分别为2.32 pmol/L、63.40 ng/mL;S-TK1在曲线下面积(AUC)、灵敏度和总有效率高于Tg(P<0.05).联合检测的阳性预测值P的Cut-off值为0.372;在AUC、灵敏度和总有效率均高于S-TK1和Tg单项检测(P<0.05).结论:单项S-TK1检测在鉴别甲状腺结节良恶性方面优于Tg;S-TK1和Tg联合检测可提高灵敏度和总有效率,故二者联合检测对鉴别甲状腺结节良恶性中有重要价值.%Objective:To investigate the value of combined serum thymidine kinase 1(S-TK1)and thyroglobulin(Tg)detection in the differential diagnosis of benign and malignant thyroid nodules.Methods:S-TK1 and Tg levels were retrospectively detected with an en-hanced chemiluminescence dot blot assay and chemiluminescence immunoassay in 81 cases of malignant thyroid nodules,62 cases of benign thyroid nodules,and 40 cases of normal controls in the Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,between October 2015 and September 2017.To compare the S-TK1 and Tg levels in each group,and to evaluate the clinical value of detecting S-TK1 and Tg,in the differential diagnosis of benign and malignant thyroid nodules,Logistic regression and Receiver Operating Characteristic Curve (ROC) were performed. Results: The S-TK1 and Tg levels in patients with malignant thyroid nodules [(5.33±3.38)pmol/L,(61.86±24.80)ng/mL]were significantly higher than in those with benign nodules[(1.40±0.99)pmol/L,(45.13± 15.80)ng/mL]and in normal controls[(1.35±0.41)pmol/L,(40.88±15.45)ng/mL](P<0.05).The ROC of S-TK1,Tg,and P of the regres-sion equation showed that the S-TK1 and Tg cut-off values were 2.320 pmol/L and 63.40 ng/mL,respectively.The area under the curve (AUC),sensitivity,and total effective rate of S-TK1 were significantly higher than those of Tg(P<0.05).The cut-off value of P was 0.372, and the AUC,sensitivity,and total effective rate were significantly higher than those of S-TK1 and Tg(P<0.05).Conclusions:S-TK1 was indicative than Tg in the differential diagnosis of benign and malignant thyroid nodules.The combined detection of S-TK1 and Tg can significantly improve the sensitivity and total effective rate of diagnosis,and as such,the combined detection of both parameters can assist the differentiation of benign and malignant thyroid nodules.