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目的探讨血清促甲状腺激素(TSH)水平对甲状腺乳头状癌(PTC)颈侧区淋巴结转移的诊断价值。方法选取2013年2月至2016年4月间新疆医科大学附属肿瘤医院收治的110例PTC患者,同时选取40例甲状腺良性结节患者作为对照,分析患者术前血清TSH与颈侧区淋巴结转移的关系。结果 PTC组患者血清TSH为(2.32±0.61)IU/ml,明显高于甲状腺结节组的(1.42±0.73)IU/ml,差异有统计学意义(P<0.05)。不同性别、年龄和单双侧PTC患者血清TSH比较,差异均无统计学意义(均P>0.05)。肿瘤直径>1cm、Ⅲ~Ⅳ期、有钙化和伴颈侧区淋巴结转移的患者比肿瘤直径≤1cm、Ⅰ~Ⅱ期、无钙化和不伴颈侧区淋巴结转移患者的血清TSH均较高,差异均有统计学意义(均P<0.05)。血清TSH诊断PTC颈侧区淋巴结转移的ROC曲线下面积为0.865,截断值为2.86IU/ml时,灵敏度为75.9%,特异度为81.1%。结论 PTC患者血清TSH水平可作为预测颈侧区淋巴结转移的指标之一。
Objective To investigate the value of serum thyrotropin (TSH) in the diagnosis of cervical lymph node metastases in the papillary thyroid carcinoma (PTC). Methods A total of 110 patients with PTC who underwent Tumor Hospital Affiliated to Xinjiang Medical University from February 2013 to April 2016 were enrolled. Forty patients with benign thyroid nodules were selected as control. The correlation between preoperative serum TSH and cervical lymph node metastasis relationship. Results The serum TSH in PTC group was (2.32 ± 0.61) IU / ml, which was significantly higher than that in thyroid nodule group (1.42 ± 0.73) IU / ml, the difference was statistically significant (P <0.05). There was no significant difference in serum TSH between patients with different gender, age and single or bilateral PTC (all P> 0.05). The tumor diameter> 1cm, stage Ⅲ ~ Ⅳ, with calcification and neck lymph node metastasis than the tumor diameter ≤ 1cm, stage Ⅰ ~ Ⅱ, without calcification and without lateral neck lymph node metastasis in patients with serum TSH were higher, The differences were statistically significant (all P <0.05). The area under the receiver operating characteristic curve (ROC) of serum TSH in diagnosis of cervical lymph node metastasis was 0.865 with a cut-off value of 2.86 IU / ml, with a sensitivity of 75.9% and a specificity of 81.1%. Conclusion Serum TSH level in patients with PTC can be used as an index to predict the metastasis of cervical lymph nodes.