Objective To investigate the diagnostic value of thyroid stimulating hormone(TSH) and anti-thyroid per-oxidase antibody (TPOAb) in Hashimoto's thyroiditis (HT) and papillary thyroid carcinoma (PTC). Methods Two hun-dred and forty-four patients came to First Affiliated Hospital of Xinjiang Medical University for treatment of thyroid diseases from February 2015 to March 2017 were grouped according to the categories of diseases;and thyroid benign tumor group were 153 cases,PTC group were 65 cases,HT group were 26 cases. Thyroid function and TPOAb levels of each group were detec-ted and compared,TSH abnormalities and TPOAb positive cases were analyzed and compared,and the value of TSH and TPO-Ab in differential diagnosis of HT was evaluated. Results The detection levels of T3,T4,FT 3 and FT4in thyroid function were not significantly different among the three groups (F=2.034, F=1.847, F=1.066, F=0.896,P=0.278, P=0.324,P=0.403,P=0.784). Compared with the level of TSH and TPOAb,the HT group was(4.90 ± 0.95)mIU/L and 84.52 (24.64,1708.50) IU/ml,which was the highest,and followed by the PTC group and the thyroid benign tumor group, there was obvious difference among the groups(F=8.211,F=17.541,P=0.046,P=0.018). Compared with TSH abnor-mal rate and TPOAb positive rate of the three groups,the HT group was 61.54% and 50%,which was the highest,and fol-lowed by the PTC group and the thyroid benign tumor group,there was obvious difference among the groups(F=19.982,F=29.047,P=0.015,P=0.007). TSH and TPOAb differential diagnosis of HT and PTC cut-off values were 4.25 mIU/L and 75.50 IU/ml,the sensitivity were 80.20% and 74.51%,specificity were 70.40% and 68.50%,Youden index were 0.506 and 0.430 respectively. Conclusion TSH and TPOAb play an important role in differential diagnosis of Hashimoto's thyroidi-tis and papillary thyroid carcinoma,which is worthy of further study.%目的 分析促甲状腺激素(TSH)、抗甲状腺过氧化物酶抗体(TPOAb)在桥本甲状腺炎(HT)和甲状腺乳头状癌(PTC)中的鉴别诊断价值.方法 选取2015年2月-2017年3月新疆医科大学第一附属医院血管甲状腺外科收治甲状腺疾病患者244例,按疾病类别分组,其中甲状腺良性肿瘤组153例,PTC组65例,HT组26例,检测并比较各组患者甲状腺功能及TPOAb水平,分析比较各组TSH异常和TPOAb阳性情况,评价TSH及TPOAb鉴别诊断HT、PTC的价值.结果 3组患者甲状腺功能T3、T4、FT3和FT4水平比较差异无统计学意义(F=2.034、1.847、1.066、0.896,P=0.278、0.324、0.403、0.784);HT组TSH及TPOAb水平最高,其次为PTC组、甲状腺良性肿瘤组,3组比较差异有统计学意义(F=8.211、17.541,P=0.046、0.018).3组TSH异常率和TPOAb阳性率比较,HT组最高(61.54%和50.00%),其次为PTC组(41.54%、26.15%)、甲状腺良性肿瘤组(22.22%、9.15%),3组比较差异有统计学意义(F=19.982、29.047,P=0.015、0.007).TSH及TPOAb鉴别诊断HT和PTC最佳 cut-off 值分别为4.25 mIU/L和75.50 IU/ml,此时敏感度分别为80.20%和74.51%,特异度分别为70.40%和68.50%,约登指数分别为0.506和0.430.结论 TSH、TPOAb在鉴别诊断桥本甲状腺炎和甲状腺乳头状癌中有一定的作用,值得进一步研究.
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