Tg与TgAb在甲状腺乳头状癌淋巴结转移中的研究进展
Research Progress of Tg and TgAb in Lymph Node Metastasis of Papillary Thyroid Carcinoma
摘要: 甲状腺球蛋白在甲状腺滤泡上皮细胞中合成并分泌的，是甲状腺中表达量最高的蛋白。目前研究认为，术前血清甲状腺球蛋白可能与甲状腺乳头状癌颈淋巴结转移相关，然而其临床最佳临界值目前尚无统一标准；甲状腺球蛋白抗体作为针对甲状腺球蛋白产生的抗体，定性TgAb状态(阳性或阴性)决定了Tg化验的风险干扰。研究表明联合检测颈部超声、FNA-Tg可以提高其临床预测价值，帮助优化新诊断PTC患者的手术计划，减少再手术次数，改善预后。本文总结相关文献内容，介绍甲状腺球蛋白及甲状腺球蛋白抗体在甲状腺乳头状癌淋巴结转移中的研究进展，并进行综述。
Abstract: Thyroglobulin is synthesized and secreted by thyroid follicular epithelial cells and is the most high-ly expressed protein in the thyroid gland. Current studies suggest that preoperative serum thy-roglobulin may be associated with cervical lymph node metastasis in papillary thyroid carcinoma. However, there is no unified standard for the optimal clinical cut-off value. Thyroglobulin antibodies as antibodies produced against thyroglobulin, qualitative TgAb status (positive or negative) deter-mines the risk of interference in Tg assays. Studies have shown that combined detection of neck ul-trasound and FNA-Tg can increase its clinical predictive value, help to optimize the operation plan of newly diagnosed PTC patients, reduce the number of reoperation, and improve the prognosis. This article summarizes the relevant literature, introduces the research progress of thyroglobulin and thyroglobulin antibody in lymph node metastasis of papillary thyroid carcinoma, and reviews it.
文章引用：高月, 吴乃君, 马铭慧, 王琪. Tg与TgAb在甲状腺乳头状癌淋巴结转移中的研究进展[J]. 临床医学进展, 2024, 14(3): 499-505. https://doi.org/10.12677/ACM.2024.143730

参考文献

[1] Haugen, B.R., Alexander, E.K., Bible, K.C., et al. (2016) 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guide-lines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid Official Journal of the American Thy-roid Association, 26, 1-133. [Google Scholar] [CrossRef] [PubMed]
[2] Bai, Y.H., Kakudo, K. and Jung, C.K. (2020) Updates in the Pathologic Classification of Thyroid Neoplasms: A Review of the World Health Organization Classification. Endocrinology and Metabolism (Seoul), 35, 696-715. [Google Scholar] [CrossRef] 
[3] 甲状腺癌诊疗指南(2022年版) [J]. 中国实用外科杂志, 2022, 42(12): 1343-1357+1363. [Google Scholar] [CrossRef] 
[4] Mazzaferri, E.L. and Massoll, N. (2002) Manage-ment of Papillary and Follicular (Differentiated) Thyroid Cancer: New Paradigms Using Recombinant Human Thyrotro-pin. Endocrine-Related Cancer, 9, 227-247. [Google Scholar] [CrossRef] [PubMed]
[5] Rogucki, M., Buczyńska, A., Krętowski, A.J. and Popławska-Kita, A. (2021) The Importance of MiRNA in the Diagnosis and Prognosis of Papillary Thyroid Cancer. Journal of Clinical Medicine, 10, Article No. 4738. [Google Scholar] [CrossRef] [PubMed]
[6] Attard, A., Paladino, N.C., Lo, Monte, A.I., et al. (2019) Skip Metasta-ses to Lateral Cervical Lymph Nodes in Differentiated Thyroid Cancer: A Systematic Review. BMC Surgery, 18, Article No. 112. [Google Scholar] [CrossRef] [PubMed]
[7] Jiwang, L., Jinghui, B., Fengqin, F., et al. (2023) Comprehensive Analysis of Clinicopathologic and Sonographic Features in Thyroid Cancer with Skip Lymph Node Metastasis: Establish and Assessment of a Prediction Nomogram. Brazilian Journal of Otorhinolaryngology, 2023, Article ID: 101301. [Google Scholar] [CrossRef] [PubMed]
[8] Holzer, G., Morishita, Y., Fini, J.B., et al. (2016) Thyroglobulin Represents a Novel Molecular Architecture of Vertebrates. Journal of Biological Chemistry, 291, 16553-16566. [Google Scholar] [CrossRef] 
[9] Trimboli, P., Treglia, G. and Giovanella, L. (2015) Preoperative Measurement of Serum Thyroglobulin to Predict Malignancy in Thyroid Nodules: A Systematic Review. Hormone and Metabolic Research, 47, 247-252. [Google Scholar] [CrossRef] [PubMed]
[10] 姚礼, 严轶群, 汪加宽, 等. 甲状腺癌颈侧区淋巴结清扫术后甲状腺功能、甲状腺球蛋白抗体、甲状腺球蛋白的变化[J]. 实用临床医药杂志, 2018, 22(7): 60-62, 66.
[11] Kim, H., Park, S.Y., Choe, J.H., et al. (2020) Preoperative Serum Thyroglobulin and Its Correlation with the Burden and Extent of Differentiated Thyroid Cancer. Cancers, 12, Article No. 625. [Google Scholar] [CrossRef] [PubMed]
[12] Chang, Q., Zhang, J., Wang, Y., et al. (2022) Nomogram Model Based on Preoperative Serum Thyroglobulin and Clinical Characteristics of Papillary Thyroid Carcinoma to Predict Cervical Lymph Node Metastasis. Frontiers in Endocrinology, 13, Article ID: 937049. [Google Scholar] [CrossRef] [PubMed]
[13] Van Kinschot, C.M.J., Peeters, R.P., Van Den Berg, S.A.A., et al. (2022) Thyroglobulin and Thyroglobulin Antibodies: Assay-Dependent Management Conse-quences in Patients with Differentiated Thyroid Carcinoma. Clinical Chemistry and Laboratory Medicine (CCLM), 60, 756-765. [Google Scholar] [CrossRef] [PubMed]
[14] Signore, A., Lauri, C., Di Paolo, A., et al. (2023) Predictive Role of Serum Thyroglobulin after Surgery and before Radioactive Iodine Therapy in Patients with Thyroid Carcinoma. Cancers, 15, Article No. 2976. [Google Scholar] [CrossRef] [PubMed]
[15] Zahra, H.O., Omran, G.A., Gewely, A.G., et al. (2021) Prognostic Value of Serum Thyroglobulin and Anti-Thyroglobulin Antibody in Thyroid Carcinoma Patients Following Thyroidec-tomy. Diagnostics, 11, Article No. 2080. [Google Scholar] [CrossRef] [PubMed]
[16] Spencer, C.A. and Lo Presti, J.S. (2008) Technology Insight: Measuring Thyroglobulin and Thyroglobulin Autoantibody in Patients with Differentiated Thyroid Cancer. Nature Clin-ical Practice Endocrinology & Metabolism, 4, 223-233. [Google Scholar] [CrossRef] [PubMed]
[17] Huang, Z., Song, M., Wang, S., et al. (2020) Preoperative Serum Thyroglobulin Is a Risk Factor of Skip Metastasis in Papillary Thyroid Carcinoma. Annals of Translational Medicine, 8, 389. [Google Scholar] [CrossRef] [PubMed]
[18] Kim, E.S., Lim, D.J., Baek, K.H., et al. (2010) Thyroglobulin Antibody Is Associated with Increased Cancer Risk in Thyroid Nodules. Thyroid, 20, 885-891. [Google Scholar] [CrossRef] [PubMed]
[19] Gao, X., Luo, W., He, L., et al. (2022) Predictors and a Prediction Model for Central Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma (CN0). Frontiers in Endocrinology, 12, Article ID: 789310. [Google Scholar] [CrossRef] [PubMed]
[20] 柴吉鑫, 陈泳, 齐艳涛, 等. 甲状腺球蛋白和抗体定量预测分化型甲状腺癌早期淋巴结转移的列线图模型[J]. 实用临床医药杂志, 2021, 25(21): 7-11.
[21] 罗家伦, 徐慧琴, 赵学峰, 等. 甲状腺球蛋白及抗甲状腺球蛋白抗体联合颈部超声在分化型甲状腺癌复发或转移灶诊断中的价值[J]. 中华临床医师杂志(电子版), 2012, 6(3): 580-583.
[22] Rosário, P.W.S., De Faria, S., Bicalho, L., et al. (2005) Ultrasonographic Differentiation between Metastatic and Benign Lymph Nodes in Patients with Papillary Thyroid Carci-noma. Journal of Ultrasound in Medicine, 24, 1385-1389. [Google Scholar] [CrossRef] [PubMed]
[23] Suh, C.H., Baek, J.H., Choi, Y.J., et al. (2017) Performance of CT in the Preoperative Diagnosis of Cervical Lymph Node Metastasis in Patients with Papillary Thyroid Cancer: A Sys-tematic Review and Meta-Analysis. American Journal of Neuroradiology, 38, 154-161. [Google Scholar] [CrossRef] 
[24] Xing, M., Clark, D., Guan, H., et al. (2009) BRAF Mutation Testing of Thyroid Fine-Needle Aspiration Biopsy Specimens for Preoperative Risk Stratification in Papillary Thyroid Cancer. Journal of Clinical Oncology, 27, 2977-2982. [Google Scholar] [CrossRef] 
[25] Howell, G.M., Nikiforova, M.N., Carty, S.E., et al. (2013) BRAF V600E Mutation Independently Predicts Central Compartment Lymph Node Metastasis in Patients with Papillary Thy-roid Cancer. Annals of Surgical Oncology, 20, 47-52. [Google Scholar] [CrossRef] [PubMed]
[26] 赵利超, 周艳红, 毛小芳, 等. BRAF~(V600E)基因突变、促甲状腺激素和甲状腺球蛋白预测甲状腺结节恶变的临床价值[J]. 福建医科大学学报, 2022, 56(5): 386-391.
[27] Haugen, B.R. (2017) 2015 American Thyroid Association Manage-ment Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: What Is New and What Has Changed? Cancer, 123, 372-381. [Google Scholar] [CrossRef] [PubMed]
[28] Snozek, C.L.H., Chambers, E.P., Reading, C.C., et al. (2007) Serum Thy-roglobulin, High-Resolution Ultrasound, and Lymph Node Thyroglobulin in Diagnosis of Differentiated Thyroid Carci-noma Nodal Metastases. The Journal of Clinical Endocrinology & Metabolism, 92, 4278-4281. [Google Scholar] [CrossRef] [PubMed]

为你推荐