分化型甲状腺癌的抗甲状腺球蛋白抗体：预测因素和结果

IF 2.3 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of the National Medical Association Pub Date : 2025-09-01 DOI:10.1016/j.jnma.2025.08.027

Matthew D. Leeder MD, BSc, Aishwarya R Krishnan MD, Andrew Day MSc, BSc, Sara Awad MD, Joshua Lakoff MD

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引用次数: 0

摘要

目的甲状腺球蛋白（Tg）是一种用于监测分化型甲状腺癌（DTC）持续或复发疾病（PRD）的生物标志物。25%的DTC患者有抗甲状腺球蛋白抗体阳性，这会干扰Tg的测量。我们的目标是了解与TgAb阳性相关的危险因素以及TgAb如何帮助疾病监测。方法对329例TgAb值有记录并行甲状腺全切除术的成年DTC患者进行回顾性研究。使用比例风险模型，我们检查了潜在危险因素与ttgab阳性之间的关系。使用Cox时间相关协变量模型，我们评估了tgab阳性与PRD之间的关系。结果淋巴细胞性甲状腺炎（LT）（HR = 2.28 [CI 1.55 ~ 3.33]）、分期>； 1 （p = 0.009）、甲状腺癌家族史（HR = 2.27 [CI 1.02 ~ 5.05]）、诊断年龄（HR = 0.98 [CI 0.97 ~ 1.00]）与tgab阳性相关。tgab阳性与PRD风险增加相关（HR=2.8 [CI 1.5-5.3]）。然而，LT与PRD风险降低相关（HR = 0.39,[CI 0.17-0.92]）。与未检测到Tg和TgAb阴性的组合相比，可检测到Tg和TgAb阳性的组合比单独检测到Tg或TgAb阳性的组合有更高的PRD风险（HR = 29.6 [CI 6.3-138.1] vs. HR = 11.8 [CI 2.8-50.2] vs. HR = 11.9 [CI 2.4-58.8]），尽管这在统计学上不显著。结论slt、分期及1期、甲状腺癌家族史、年龄较小与tgab阳性相关。虽然TgAb阳性与PRD风险增加有关，但LT患者的PRD风险较低。合并TgAb阳性和可检测Tg的患者发生PRD的风险可能更高。

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Anti-Thyroglobulin Antibody in Differentiated Thyroid Cancer: Predictors and Outcomes

Objective

Thyroglobulin (Tg) is a biomarker used to monitor for persistent or recurrent disease (PRD) in differentiated thyroid cancer (DTC). 25% of DTC patients have positive antithyroglobulin antibodies which interfere with Tg measurements. We aim to understand what risk factors are associated with TgAb-positivity and how TgAb can aid in disease monitoring.

Methods

We retrospectively studied 329 adult DTC patients with documented TgAb values who underwent total thyroidectomy. Using a proportional hazards model, we examined the association between potential risk factors and TgAb-positivity. Using a Cox model for time-dependent covariates, we evaluated the relationship between TgAb-positivity and PRD.

Results

Lymphocytic thyroiditis (LT) (HR = 2.28 [CI 1.55-3.33]), stage > 1 (p = 0.009), family history of thyroid cancer (HR = 2.27 [CI 1.02-5.05]), and age at diagnosis (HR = 0.98 [CI 0.97-1.00]) were associated with TgAb-positivity. TgAb-positivity was associated with increased PRD risk (HR=2.8 [CI 1.5-5.3]). However, LT was associated with decreased PRD risk (HR = 0.39, [CI 0.17-0.92]). When compared to combined undetectable Tg and negative TgAb, combined detectable Tg and positive TgAb had a higher hazard of PRD than detectable Tg or positive TgAb alone (HR = 29.6 [CI 6.3-138.1] vs. HR = 11.8 [CI 2.8-50.2] vs. HR = 11.9 [CI 2.4-58.8]), although this was statistically insignificant.

Conclusions

LT, stage > 1, family history of thyroid cancer, and younger age were associated with TgAb-positivity. While TgAb- positivity is associated with increased PRD risk, patients with LT had a lower PRD risk. PRD risk may be higher in patients with combined positive TgAb and detectable Tg.

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来源期刊

Journal of the National Medical Association 医学-医学：内科

CiteScore

4.80

自引率

3.00%

发文量

139

审稿时长

98 days

期刊介绍： Journal of the National Medical Association, the official journal of the National Medical Association, is a peer-reviewed publication whose purpose is to address medical care disparities of persons of African descent. The Journal of the National Medical Association is focused on specialized clinical research activities related to the health problems of African Americans and other minority groups. Special emphasis is placed on the application of medical science to improve the healthcare of underserved populations both in the United States and abroad. The Journal has the following objectives: (1) to expand the base of original peer-reviewed literature and the quality of that research on the topic of minority health; (2) to provide greater dissemination of this research; (3) to offer appropriate and timely recognition of the significant contributions of physicians who serve these populations; and (4) to promote engagement by member and non-member physicians in the overall goals and objectives of the National Medical Association.