NLR、TgAb与甲状腺乳头状癌颈部淋巴结转移的关系

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Abstract Objective To explore the relationship between neutrophil to lymphocyte ratio (NLR), thyroglobulin antibody (TgAb) and cervical lymph node metastasis of papillary thyroid carcinoma. Methods A clinical study was conducted on 135 patients with papillary thyroid carcinoma diagnosed and treated in Huainan First People′s Hospital from January 2017 to September 2019. The patients were divided into the non-metastatic group (72 cases) and the metastatic group (63 cases) according to whether they had cervical lymph node metastasis. Clinical data and medical history of patients in the two groups were recorded. NLR value was measured by automatic blood cell analyzer, biochemical indicators of the patients were measured by automatic biochemical analyzer, and serum TgAb level was measured by enzyme-linked immunosorbent assay. Logistic regression model was used to analyze the influencing factors of cervical lymph node metastasis, and receiver operating characteristic (ROC) curve was used to predict the value of NLR and serum TgAb for cervical lymph node metastasis. Results Tumor diameter, uric acid, urea nitrogen, creatinine, total bilirubin, NLR and serum TgAb were significantly higher in the metastatic group than in the non-metastatic group (P ＜ 0.05). There was no statistically significant difference between the two groups in gender, age, history of hypertension, history of coronary heart disease, history of diabetes, combined goiter, number of tumors, cholesterol, triglyceride, high density lipoprotein and low density lipoprotein (P ＞ 0.05). Logistic regression model showed that elevated NLR and serum TgAb levels were independent risk factors for cervical lymph node metastasis in patients with papillary thyroid carcinoma (P ＜ 0.05). The clinical value of NLR combined with serum TgAb [AUC = 0.874, 95%CI (0.816 - 0.932), sensitivity = 89.76%, specificity = 90.58%] in predicting cervical lymph node metastasis was significantly better than that of NLR [AUC = 0.753, 95%CI (0.673 - 0.833), sensitivity = 76.53%, specificity = 79.12%] and serum TgAb [AUC = 0.796, 95%CI (0.724 - 0.869), sensitivity = 80.47%, specificity = 83.91%] alone. Conclusion Abnormally elevated levels of NLR and serum TgAb levels are closely related to the occurrence of cervical lymph node metastasis in patients with papillary thyroid carcinoma. Early combined detection is helpful to predict the risk of cervical lymph node metastasis in patients with papillary thyroid carcinoma, so as to provide reference for clinical development of targeted intervention programs.

Key words： Neutrophil to lymphocyte ratio Thyroglobulin antibody Papillary thyroid carcinoma Cervical lymph node metastasis

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	XU Ke YANG Fang XIE Yinghai WANG Peibin

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XU Ke YANG Fang XIE Yinghai WANG Peibin. Relationship between NLR, TgAb and cervical lymph node metastasis in papillary thyroid carcinoma[J]. 中国医药导报, 2020, 17(11): 93-97.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2020/V17/I11/93

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