ABSTRACT
Objective:To investigate the value of combined serum thymidine kinase 1(S-TK1)and thyroglobulin(Tg)detection in the differential diagnosis of benign and malignant thyroid nodules.Methods:S-TK1 and Tg levels were retrospectively detected with an en-hanced chemiluminescence dot blot assay and chemiluminescence immunoassay in 81 cases of malignant thyroid nodules,62 cases of benign thyroid nodules,and 40 cases of normal controls in the Sichuan Academy of Medical Sciences&Sichuan Provincial People's Hospital,between October 2015 and September 2017.To compare the S-TK1 and Tg levels in each group,and to evaluate the clinical value of detecting S-TK1 and Tg,in the differential diagnosis of benign and malignant thyroid nodules,Logistic regression and Receiver Operating Characteristic Curve (ROC) were performed. Results: The S-TK1 and Tg levels in patients with malignant thyroid nodules [(5.33±3.38)pmol/L,(61.86±24.80)ng/mL]were significantly higher than in those with benign nodules[(1.40±0.99)pmol/L,(45.13± 15.80)ng/mL]and in normal controls[(1.35±0.41)pmol/L,(40.88±15.45)ng/mL](P<0.05).The ROC of S-TK1,Tg,and P of the regres-sion equation showed that the S-TK1 and Tg cut-off values were 2.320 pmol/L and 63.40 ng/mL,respectively.The area under the curve (AUC),sensitivity,and total effective rate of S-TK1 were significantly higher than those of Tg(P<0.05).The cut-off value of P was 0.372, and the AUC,sensitivity,and total effective rate were significantly higher than those of S-TK1 and Tg(P<0.05).Conclusions:S-TK1 was indicative than Tg in the differential diagnosis of benign and malignant thyroid nodules.The combined detection of S-TK1 and Tg can significantly improve the sensitivity and total effective rate of diagnosis,and as such,the combined detection of both parameters can assist the differentiation of benign and malignant thyroid nodules.
ABSTRACT
Objective To evaluate the effect of 131 iodine(131I) therapy in medium and large goiter with hyperthyroidism in order to investigate the influence of pretreatment with antithyroid drugs (ATD) methimazole(MMI) and propylthiouracide (PTU) on 131I therapy.Methods A total of 338 hyperthyroidism patients (136 cases for male,202 cases for female) with thyroid mass greater than 40 grams were treated with 131I in the People's Hospital of Sichuan Province.Thyroid function,thyroid 131I uptake ratio and thyroid imaging were measured before treatment were measured 1-3 months later after administration of 131I,and they were followed up for 6 months to 4 years.Results There were statistical difference between pretreatment and 3 months later of 131I therapy in terms of free triiodothyronine (FT3),(Free thyroxine) FT4.The level of FT3 decreased from (31.9 ± 16.2) pmol/L to (7.8 ±8.5) pmol/L(t =23.9,P =0.000) and level of FT4 decreased from (58.8 ± 22.2) pmol/L to (19.4 ± 16.9) pmol/L(t =25.4,P =0.000).Among 338 patients,109 patients (32.2％) were developed hypothyroidism,and 91 patients (26.9％) were cured,91patients (26.9％) with improved state,20 patients(5.9％) with ineffective and 27 patients(8.0％) with relapse after administration of 131I.The total effective rate was 94.1％ (318/338).Thyroid weight,levels of FT3,FT4,thyroglobulin antibody(TGA),thyroid microsomal antibody(MCA) in effective group were (49.8 ± 9.97) g,(32.5 ± 16.3) pmol/L,(59.5 ± 22.2) pmol/L,(43.6 ± 35.3) ％,(30.1 ± 22.6) ％ respectively,and were (56.9±15.7) g,(22.8 ± 12.8) pmol/L,(47.9 ±20.3) pmol/L,(22.8±30.0)％,(15.3 ±20.5)％ respectively in ineffective group.There were statistically significant differences between the ineffective group and effective group (t =2.932,2.602,2.287,2.501,2.766 ; P =0.000,0.010,0.023,0.013,0.006).Logistic regression analysis was showed that weight of thyroid and serum FT3 were the most important factors in affecting 1131 therapy.Conclusion 131 I therapy for medium and large-sized goiter with hyperthyroidism is safe and effective.ATD may not reduce the effectiveness of subsequent 131I of hyperthyroidism.Thyroid weight and FT3 are the key influential factors in affecting 131I.