基础血清降钙素值对甲状腺髓样癌的鉴别诊断价值

刘茜辉; 聂鑫; 贺勇; 银梦婷; 李贵星

doi:10.12182/20230160513

基础血清降钙素值对甲状腺髓样癌的鉴别诊断价值

Value of Baseline Calcitonin for Differential Diagnosis of Medullary Thyroid Cancer

摘要

摘要:
目的分析基础血清降钙素值（bCtn）在有甲状腺结节的高降钙素血症人群中对甲状腺髓样癌（MTC）的辅助诊断效能，以及术前血清bCtn、癌胚抗原（CEA）水平与MTC肿瘤分期的关系。
方法系统回顾四川大学华西医院2011–2020年收治的58名MTC和2016–2020年收治的84名非MTC患者的临床、病理、影像和检验资料，建立ROC曲线计算bCtn和CEA对MTC的诊断效能，比较不同肿瘤原发灶的情况和区域淋巴结受累情况的MTC患者术前bCtn、CEA水平差异。
结果 bCtn从有甲状腺结节的高降钙素血症人群中诊断MTC的最佳截断值为31.54 pg/mL（男性）和22.60 pg/mL（女性）。不同T分期的MTC患者术前bCtn水平差异有统计学意义（H=16.166，P=0.001）、术前CEA水平差异有统计学意义（H=9.447，P=0.024）。不同N分期的MTC患者术前bCtn水平差异有统计学意义（H=7.919，P=0.019）、术前CEA水平差异有统计学意义（H=7.934，P=0.019）。
结论血清bCtn在有甲状腺结节的高降钙素血症人群中诊断MTC的最佳截断值分别为31.54 pg/mL（男性）和22.60 pg/mL（女性）。

Abstract:
Objective To analyze the efficacy of using baseline calcitonin (bCtn) for auxiliary diagnosis of medullary thyroid cancer (MTC) in the hypercalcitoninemic population with thyroid nodules and to explore the relationship between preoperative levels of bCtn and carcinoembryonic antigen (CEA) and MTC staging.
Methods The clinical, pathological, imaging, and lab test data of 58 MTC patients and 84 non-MTC patients were retrospectively reviewed in the study. The patients were hospitalized at West China Hosptal, Sichuan University between 2011 and 2020. Receiver operating characteristic (ROC) curves were constructed to calculate the MTC diagnostic efficacy of bCtn and CEA. The differences in the preoperative bCtn and CEA levels of MTC patients with different primary tumor sites and regional lymph node involvement were compared.
Results The bCtn cutoff values were 31.54 pg/mL for men and 22.60 pg/mL for women for diagnosing MTC in the hypercalcitoninemic population with thyroid nodules. There were statistical differences in preoperative bCtn levels (H=16.166, P=0.001) and in preoperative CEA levels (H=9.447, P=0.024) in MTC patients of different T stages. There were statistical differences in preoperative bCtn levels (H=7.919, P=0.019) and in preoperative CEA levels (H=7.934, P=0.019) in MTC patients of different N stages.
Conclusion The best bCtn cutoff values for the diagnosis of MTC in the hypercalcitoninemic population with thyroid nodules and are 31.54 pg/mL for men and 22.60 pg/mL for women.

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