天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (7): 739-741.doi: 10.11958/20170428

• 临床研究 • 上一篇    下一篇

血清 midkine 对甲状腺球蛋白抗体阳性甲状腺癌患者转移病灶的预测价值

贾强，张春梅，孟召伟，谭建   

  1. 天津医科大学总医院核医学科 （邮编 300052）
  • 收稿日期:2017-04-07 修回日期:2017-05-16 出版日期:2017-07-15 发布日期:2017-08-08
  • 基金资助:
    国家自然科学基金资助项目 （81571709）； 天津市科委重点课题资助项目 （16JCZDJC34300）

Predictive value of serum midkine for metastatic lesions in thyroid cancer patients with positive thyroglobulin antibody

JIA Qiang,ZHANG Chun-mei,MENG Zhao-wei,TAN Jian   

  1. Department of Nuclear Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China
  • Received:2017-04-07 Revised:2017-05-16 Published:2017-07-15 Online:2017-08-08

PDF (PC)

3664

摘要： 目的 研究 midkine 在甲状腺球蛋白抗体（TgAb）阳性的分化型甲状腺癌患者首次 131I 治疗前， 对甲状腺癌是否有转移病灶的预测价值。方法 根据严格的纳入和排除标准， 入选 151 例分化型甲状腺癌患者， 运用酶联免疫吸附法测定 midkine（MK）水平。最终有转移病灶的 TgAb 阳性的分化型甲状腺癌患者 28 例， 无转移病灶者123例。用受试者工作特征（ROC）曲线评估患者 131I 治疗前 MK 预测转移病灶的价值。结果 有转移病灶的分化型甲状腺癌患者的 MK 水平高于无转移的患者。MK 显示出良好的诊断价值， 最佳截断值为 550 ng/L 时， 诊断准确率为83%， ROC 曲线下面积为 0.856 （P<0.001）。结论 当 TgAb 阳性而不适合用甲状腺球蛋白做标志物时， MK 可以作为预测分化型甲状腺癌转移的标志物。

关键词: 甲状腺肿瘤, 甲状腺球蛋白, ROC 曲线, midkine, 分化型甲状腺癌, 甲状腺球蛋白抗体, 131I 治疗

Abstract: Objective To investigate the predicative value of midkine (MK) as a cancer biomarker for metastatic lesions in differentiated thyroid cancer (DTC) patients with positive thyroglobulin antibodies (TgAb) before the first 131I therapy. Methods MK levels were measured by enzyme- linked immunosorbent assay in 151 recruited DTC patients included in this study according to strict inclusion and exclusion criteria. There were 28 TgAb positive DTC patients with metastases and 123 DTC patients without metastases. The value of pre- 131I-ablative MK to predict metastasis was assessed by receiver operating characteristic (ROC) curves in these two groups of patients. Results MK levels were significantly higher in TgAb positive DTC patients than those in DTC patients without metastases. MK levels showed good diagnostic value, with an area under the curve of 0.856 (P<0.001), and a diagnostic accuracy of 83% at the optimal cut-off value of 550ng/L. Conclusion Results show that MK can potentially be used as a surrogate biomarker for predicting DTC metastases when thyroglobulin is not suitable due to TgAb positivity.

Key words: thyroid neoplasms, thyroglobulin, ROC curve, midkine, differentiated thyroid cancer, thyroglobulin antibodies, 131I treatment

中图分类号: