Clinical significances of serum thyroid stimulating hormone, thyroid peroxidase antibody and thyroglobulin antibody in differential diagnosis of benign and malignant thyroid nodules

Zhang Hanyue; Duan Wenbing; Zhang Lulu; Xu Rui; Liu Yigang; Wang Yanhong; Tang Wen; Liu Yun

doi:10.3760/j.issn.1673-4777.2019.07.011

Abstract：Objective To explore the clinical significances of serum thyroid stimulating hormone(TSH),thyroid peroxidase antibody (TPO-Ab) and thyroglobulin antibody (Tg-Ab) in differential diagnosis of benign and malignant thyroid nodules.Methods A total of 381 patients with thyroid nodules undergoing surgical resection in Shandong Provincial Hospital Affiliated to Shandong University from January 1st,2017 to June 30th,2017 were enrolled.According to postoperative pathological results,250 patients were diagnosed of benign thyroid nodules (BTN group);77 patents were diagnosed of thyroid cancer (TC group);54 patients had thyroid cancer with nodular goiter(TC + NG group).Two hundred healthy people were enrolled as normal control group(N group).Serum levels and positive rates of TSH,TPO-Ab and Tg-Ab were detected before surgery.Relations among serum TSH,TPO-Ab,Tg-Ab and clinicopathological features of thyroid cancer were analyzed.Risk factors of thyroid cancer were analyzed.Results Levels of TSH,TPO-Ab and Tg-Ab in TC group and TC + NG group were significantly higher than those in N group and BTN group [2.37 (1.66,3.30),2.26 (1.55,3.28) mIU/L vs 1.96 (1.41,2.55),1.86(1.28,2.49)mIU/L;28.00(14.28,37.95),23.89(10.16,28.53) kIU/L vs 13.60(8.20,22.00),16.49(12.92,28.00) kIU/L;19.25(15.00,148.79),19.16(10.00,186.50) kIU/L vs 13.32(9.00,36.28),14.24(12.74,40.17)kIU/L];the level of TPO-Ab in BTN group was significantly higher than that in N group (all P ＜ 0.01).Positive rates of TSH,Tg-Ab and TPO-Ab in TC group and TC + NG group were significantly higher than those in N group and BTN group (all P ＜ 0.01);the positive rate of TPO-Ab in TC group was significantly higher than that in TC + NG group(P ＜0.05).There were significant correlations of serum TSH level with gender,lesion diameter,lymph node metastasis and tumor stage(all P ＜0.05).There was no correlation among TPO-Ab,Tg-Ab and clinicopathological features of tumor (P ＞ 0.05).Multivariate logistic regression showed that elevated TSH and Tg-Ab were independent risk factors of thyroid cancer(odds ratio =2.043,1.080;95％ confidence interval:1.480-2.830,1.029-1.103;P ＜0.001).Conclusion Serum levels of TSH,TPO-Ab and Tg-Ab are closely related to the occurrence and development of thyroid cancer and show great values in the differential diagnosis of benign and malignant thyroid nodules.