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目的:评估组织多肽抗原(TPA)在甲状腺癌诊断与疗效监测中的应用价值。方法:用化学发光法检测138例甲状腺癌患者、25例甲状腺良性疾病患者及65名健康对照者血清TPA水平,同时测定甲状腺癌标志物(TG、CEA),对结果进行比较分析。结果:在甲状腺癌组中,血清TPA水平(中位数为108.8U/L)明显高于甲状腺良性疾病患者(中位数为44.46U/L)和健康对照(中位数为55.63U/L)(均P<0.01)。根据受试者操作特性曲线(ROC曲线)分析,TPA检测甲状腺癌的临界值为78U/L,敏感度为63.04%,特异度为88.9%。相比于其他甲状腺癌标志物(CEA、TG),灵敏度较高,特异度稍低。此外,甲状腺患者血清TPA水平及阳性率随着肿瘤分期的升高而升高,淋巴结转移患者TPA水平显著高于未转移者(均P<0.05)。TPA水平与疗效也密切相关,临床治疗有效时TPA下降,而病情恶化或出现转移时则升高。结论:TPA测定有助于甲状腺癌的诊断和疗效监测。
Objective: To evaluate the value of tissue polypeptide antigen (TPA) in the diagnosis and treatment of thyroid cancer. Methods: The levels of serum TPA in 138 cases of thyroid cancer, 25 cases of benign thyroid disease and 65 healthy controls were detected by chemiluminescence method. The thyroid cancer markers (TG and CEA) were also measured and the results were compared. Results: In the thyroid cancer group, serum TPA level (median 108.8U / L) was significantly higher than that in patients with thyroid benign disease (median 44.46U / L) and healthy controls (median 55.63U / L ) (All P <0.01). According to the receiver operating characteristic curve (ROC curve) analysis, the critical value of TPA for detecting thyroid cancer was 78U / L, the sensitivity was 63.04% and the specificity was 88.9%. Compared with other thyroid cancer markers (CEA, TG), the sensitivity is higher and the specificity is lower. In addition, serum TPA level and positive rate in patients with thyroid gland elevated with tumor stage, and TPA levels in patients with lymph node metastasis were significantly higher than those without metastasis (all P <0.05). The level of TPA is also closely related to the curative effect. When the clinical treatment is effective, the TPA is decreased, and the condition is deteriorated or the metastasis is increased. Conclusion: TPA is helpful for the diagnosis and treatment of thyroid cancer.