Analysis Of The Value Of Tg And TAP In The Diagnosis Of Differentiated Thyroid Cancer And Monitoring Its Recurrence After Treatment

Bacgroundthyroid carcinoma（TC）accounts for about 5.12%of all malignant lesions.According to the pathological types,it is divided into anaplastic thyroid carcinoma（ATC）,papillary thyroid carcinoma（PTC）and medullary thyroid carcinoma cancer（MTC）and follicular thyroid carcinoma（FTC）.Among them,PTC and FTC are also called differentiated thyroid cancer（DTC）.Current studies have shown that thyroglobulin（Tg）is the main serum marker for the detection of recurrence and metastasis after PTC and FTC,but the early diagnostic value of Tgfor these two tumors is not consistent.Detection of tumor markers is of great value in the early diagnosis and follow-up monitoring of some malignant tumors after treatment.The content of abnormal glycoprotein（TAP）in blood will change in the early stage of tumor,which has effective clinical guiding value for early diagnosis and follow-up observation of malignant tumors after treatment.Tgis a DTC specific monitoring index,which is clinically used to monitor recurrence after DTC treatment,while TAP is a broad spectrum tumor marker,which is mainly used in tumor diagnosis.If they are combined,they can complement each other and increase the accuracy of DTC diagnosis and recurrence monitoring after treatment.ObjectiveThe main purpose of this paper is to study the efficacy of Tg,TAP and their combination in the diagnosis of PTC and FTC.For DTC,on the other hand,qing postoperative patients,under the influence of exclusion of positive TgAb,explore the TgAb negative cases,Tg,TAP a separate application and combined application of both transfer treatment for the monitoring of the DTC indices such as sensitivity,specific and accurate comparison,research application and the effect of combined use of both individual differences,and find the best cutoff value.MethodsThis study retrospectively analyzed patients hospitalized in Xinxiang Central Hospital from January 2018 to December 2019.The patients were divided into thyroid cancer patients（thyroid tumor patients）group 98 cases（5 cases of follicular carcinoma,93 cases of papillary carcinoma）and benign thyroid nodular lesions group（101 cases of benign thyroid nodular lesions confirmed by needle aspiration cytology or pathology,such as nodular goiter,hyperthyroidism or hypothyroidism）.Nodular goiter（n=25）,benign thyroid adenoma（n=20）,subacute thyroiditis（n=18）,hyperthyroidism（n=16）,fibrotic thyroiditis（n=7）and chronic lymphocytic thyroiditis（n=15）.The contents of Tgand TAP in thyroid cancer patients group and thyroid benign lesions group were detected.Comparison of the percentage of positive expression in the two groups by single detection and combined detection;After thyroidectomy or ¹³¹I treatment,thyroid cancer patients were followed up for 1-2 years to observe the expression levels of Tgand TAP in patients with metastasis and without metastasis,and to compare the combined monitoring of Tgand TAP with Tgalone,and to find the optimal cut-off value of Tgand TAP.IBM SPSS20.0 statistical software was used for calculation.The test level wasα=0.05,P<0.05 was considered statistically significant.Binary Logistic analysis was used to predict the effect of ps-Tgand TAP on postoperative metastasis in patients with DTC.receiver operatingcharacteristic curve（ROC）was drawn to evaluate the sensitivity,specificity,cut-off point and area under the curve of ps-Tgand TAP in monitoring postoperative metastasis in DTC patients.Results1.The positive rates of TAP alone in the diagnosis of DTC and benign thyroid nodules were 79.59%and 33.66%,and the comparison between them was statistically significant（x²=40.795,P<0.001）.The positive rates of Tgalone in the diagnosis of DTC and benign thyroid nodules were 47.96%and 32.67%,and the comparison between them was statistically significant（x²=4.220,P=0.040）.The positive rates of TC and benign thyroid nodules were 92.86%and 57.43%,respectively,and the comparison was statistically significant（x²=31.334,P<0.001）.2.Among 73 DTC patients with negative TgAb during the follow-up review of one year to two year,12 patients were diagnosed with metastasis and 61 patients were not.The average Tgvalue of patients with metastasis was 13.99±14.11ng/ml,and the average TAP value was 234.97±124.81μm².In patients without metastasis,the average Tgvalue was0.23±0.75ng/ml,and the average TAP value was 112.79±63.49μm².3.The sensitivity,specificity,precision,false-negative rate and false-positive rate of serum Tgwere 75.00%,81.97%,80.82%,25.00%and 18.03%,respectively,in 73 DTC patients with negative TgAb during the follow-up review of one year to two year.The sensitivity,specificity,precision,false negative rate and false positive rate of TAP diagnosis were 75.00%,57.38%,60.27%,25.00%and 42.62%,respectively.The sensitivity,specificity,precision,false-negative rate and false-positive rate of combined diagnosis were91.67%,50.82%,57.53%,8.33%and 49.18%,respectively.4.Excluding the influence of TgAb positive factors,univariate Logistic regression analysis was performed to predict metastasis indexes,and the results showed that the difference of ps-Tgand TAP indexes was statistically significant.5.According to the ROC curve,the cut-off point of ps-Tgin diagnosing metastasis after DTC was 6.235μg/L,the sensitivity and specificity were 75%and 90.2%,and the area under the ROC curve was 0.900.The cut-off point of TAP in diagnosing metastasis after DTC was 195.605μm²,the sensitivity was 66.7%,85.2%,and the area under the ROC curve was 0.762.Conclusion1.In the diagnosis of DTC alone,the positive rate of TAP is better than that of Tg;Combined diagnosis of DTC is better than single index.2.When the cut-off value of ps-Tgwas 1μg/L and TAP was 121μm2,the effect of serum ps-Tgalone in the diagnosis of metastasis was better than that of TAP alone in the diagnosis of metastasis after DTC,but the diagnostic efficacy was limited.3.The optimal cut-off values of ps-Tgand TAP for monitoring metastasis after DTC were 6.235μg/L and 195.605μm²,respectively.