【Abstract】Objective To study the relation between iodine and experimental autoimmune thyroiditis(EAT). Methods Establishment of animal model was performed with iodine and thyroglobulin(TG).The rats were randomly divided into 5 groups: normal control group(NC), low iodine group (LI,500 μg/L), high iodine group(HI,500 mg/L), TG+Freund adjuvant group(TG) and TG+Freund adjuvant+HI group(TG+HI). The rats in TG group and TG+HI group were rejected hypodermically with TG emulsified by complete Freund adjuvant, and strengthen immunity was conducted with TG emulsified by incomplete Freund adjuvant on 15 days. After that, strengthen immunity was done weekly till the end of the experiment. Serum TGAb and TPOAb were measured by radioimmunoassay. Observation of the pathological changes of thyroid gland was also done. Results Thyroid follicular destruction and lymphocytic infiltration in the TG+HI group (3.83±1.72) and HI group (3.00±0.89) were significantly higher than that of the NC group(0.67±0.82)，P＜0.05. The results of the TG group were higher compared with the NC group, but there were no significant differences between them（Pgt;0.05）. The levels of TGAb in the TG+HI (4.990±1.505)，HI (3.589±1.240) and TG group (4.883±1.198) were significant higher than those of the NC group (0.642±0.454) and the LI group (0.707±0.240)，P＜0.01. The levels of TPOAb in TG+HI group (1.475±0.523) and TG group (1.316±0.606) were significantly higher than those of the NC group (0.365±0.196) and the LI group（P＜0.01）. Serum TGAb and TPOAb levels were positively correlated with the histological grades of lymphocytic thyroiditis(r=0.9,P＜0.05）. Conclusion Excessive iodine intake may induce the occurrence of EAT. The induction of EAT with excessive iodine and TG may be more efficient.
目的总结原发性甲状腺鳞癌的诊治经验。方法回顾分析我院1996～2001年收治的12例原发性甲状腺鳞癌患者的临床资料。结果单纯性鳞癌4例，合并甲状腺其它疾病8例。主要临床表现为颈部包块和声嘶。单纯性鳞癌免疫组化甲状腺球蛋白染色阳性3例，阴性1例。12例患者中10例行姑息性切除者于术后1年内死亡，2例行根治性切除者存活时间超过3年。结论原发性甲状腺鳞癌呈高度恶性，可与甲状腺其它良、恶性疾病并存； 要重视对该病的诊断和鉴别诊断，免疫组化甲状腺球蛋白染色可提高确诊率； 根治性手术切除加综合治疗是提高其生存率的关键。
Thirty patients with heperthyroidism were investigated for triiodothyronine (T3), thyroxine (T4), thyroid stimulating hormone (TSH), thyromicrosome antibody (TMA), thyroglobulin antibody (TGA) and hydrocortisone before and after operation. The levels of serum T3, T4, TGA, TMA were markedly decreased after operation, and the level of hydrocortisone farther decreased from the preoperative low level. But only a little decrease in TSH level was found as compared with that before operation. The assay of these hormones and antibodies has very important clinical significance for judgement of the effect of operation and prevention of crisis of hyperthyroidism.
目的 探讨甲状腺疾病患者血清游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺激素(TSH)、甲状腺球蛋白(TG)含量水平变化与临床意义。 方法 采用电化学发光法对2009年1月-6月诊断的725例甲状腺疾病患者的FT3、FT4、TSH、TG进行检测，对各类甲状腺疾病的激素含量进行统计分析。 结果 血清中此类激素的水平与甲状腺的功能状态呈平行关系。 结论 在不同甲状腺疾病患者血清FT3、FT4、TSH、TG变化各有特点，有助于临床鉴别诊断。
【摘要】 目的 探讨慢性丙型肝炎患者干扰素治疗前后血清自身抗体的合并状况。 方法 回顾性分析2005年2月-2008年2月66例慢性丙型肝炎患者应用干扰素治疗前后的检测结果，观察治疗前后自身抗体合并状况及与干扰素疗效的关系。 结果 ①66例慢性丙型肝炎患者中39例自身抗体阳性，阳性率59.1%（39/66），主要为ANA；②自身抗体的产生与年龄相关，而与性别、HCVRNA定量无关；③自身抗体阳性组干扰素应答率66.7% （26/39）明显高于阴性组40.7%（11/27），二者比较差异有统计学意义；④干扰素治疗后，自身抗体阴性组自身抗体检出率为44.4%（12/27），但滴度均lt;1∶320；治疗前抗甲状腺球蛋白抗体阳性患者会出现较高的甲状腺功能异常率。 结论 慢性丙型肝炎合并血清自身抗体阳性的患者干扰素应答率高于阴性组，但应注意抗甲状腺球蛋白抗体，以预测不良反应。【Abstract】 Objective To explore the consolidation of serum autoantibodies in chronic hepatitis C patients treated with interferon. Methods The clinical data of 66 patients with chronic hepatitis C treated with interferon from February 2005 to February 2008 were retrospectively analyzed. The relationship between the consolidation of serum autoantibodies and the effect of interferon was observed. Results ①There were 39 patients with positive autoantibodies; the positive rate was 59.1% (39/66) and ANA was the main antibody. ②The appearance of autoantibodies correlated with the patients′ ages but not with the sexes and CVRNA quantification. ③The interferon response rate in autoantibodies positive group was 66.7% (26/39) which was much higher than that in the negative group; the difference between the two groups was significant. ④After the interferon treatment, the autoantibody detection rate in autoantibody negative group was 44.4%(12/27)and the titer was lower than 1:320; before the treatment, the anti-thyroglobulin antibody-positive patients had a higher rate of thyroid dysfunction. Conclusion The interferon response rate in chronic hepatitis C patients with positive serum autoantibodies is higher than that in the patients with negative serum autoantibodies. Anti-thyroglobulin antibodies should be noted to predict the adverse effects.
摘要:目的:采用Meta分析的方法评价甲状腺球蛋白在甲状腺良性疾病和甲状腺癌中的临床意义。方法:通过检索MEDLINE、EMBASE、The Cochrane Library, 中国生物医学文献数据库、中国学术期刊全文数据库和其他方式广泛收集文献。根据QUADAS质量评价标准评价纳入文献的质量,用MetaDisc软件对其敏感度、特异度、阳性似然比、阴性似然比等进行合并分析,并进行异质性检验,绘制综合受试者工作特征曲线(summary receiver operator characteristic curve,SROC)。结果:最终纳入5篇文献。合并敏感度0.60,合并特异度0.83,合并比值比2.68, SROC下面积(AUC)=0.645 4。结论:现有研究证实:甲状腺球蛋白在甲状腺癌中的阳性率是甲状腺良性疾病中的2.68倍,有统计学差异,但敏感度不高。尚需更多设计严谨、科学的临床试验进一步证实。Abstract: Objective: To evaluate the quality of the current studies involving the value of serum thyroglobulin in the diagnosis of thyroid benign diseases and thyroid carcinoma. Methods: We comprehensive collected current studies about serum thyroglobulin in thyroid benign diseases and thyroid carcinoma by computer and manual searches. QUADAS items were used for quality assessment in our systematic review. Metadisc software was used to analyze pooled sensitivity, pooled specificity,pooled positive likelihood ratio and pooled negative likelihood ratio,pooled diagnostic test odds ratio and heterogeneity test,and draw summary receiver operator characteristic curve (SROC). Results: Totally 5 studies were included. To identify thyroid benign diseases and thyroid carcinoma, pooled sensitivity was 0.60, pooled specificity was 0.83,pooled odds ratio was 2.68, the area under curve (AUC) was 0.645 4.Conclusion: The results of statistic alanalysis showed that the positive rate of thyroglobulin in thyroid carcinoma is 2.68 times more than in benign thyroid diseases. There was significant difference. But sensitivity was not high and reporting quality of the studies was relatively poor. The conclusion still need more clinical trials to confirm.
ObjectiveTo investigate the primary culture method of human papillary thyroid carcinoma (PTC) cells for a long term and establish a monitoring and verification measures. MethodsPTC cells were isolated following routine procedures and cultured in the DMEM supplemented with 10% fetal bovine serum, glutamine, and 20 ng/ml epidermal growth factor (EGF). Thyroglobulin (Tg) and thyroperoxidase (TPO) in nutrient solution and specific antigen Tg expression of PTC cells cultured for different days were observed. ResultsThe PTC cells grew satisfactorily up to 45 days of incubation. Tg content in nutrient solution expressed the training period of a linear singular parabolic, achieved peak value (985.2 μg/L) at about 14 d. TPO had not been detected in nutrient solution. The Tg expressed positively by immunization fluorescent dyeing. ConclusionsPTC cells cultured in the present method can survive to over 45 days. A brief monitoring and evaluation systems of PTC cells has been established. This report prompts that cultured cells within 14 days maybe more suitable to gene research and provide alternative to the basic research of PTC events and features.
【Abstract】ObjectiveTo discuss the value of thyroglobulin (TG) in diagnosis and treatment of differentiated thyroid cancer (DTC) patients. MethodsLiteratures on measurement and clinical application of serum TG were reviewed. ResultsImmunometric assay (IMA) was adopted by most clinical lab.TG antibody （TGAb） should be measured in the same sample of DTC patient.TG detection before operation is of less value in confirming diagnosis of DTC, but is helpful in differential diagnosis of histopathological type of DTC.TG detection after operation is very important in patients who had undergone total thyroidectomy.Monitoring TG after thyroid hormone withdrawal or recombinant human TSH stimulation is more sensitive to identify tumor recurrence. ConclusionMonitoring TG after total thyroidectomy has great value in followup of DTC patients.
ObjectiveTo compare the diagnostic efficacy of serum thyroglobulin (Tg), diagnostic 131I whole-body scan (D-WBS), neck ultrasound for diagnosing metastasis and recurrence of differentiated thyroid carcinoma (DTC). MethodsFrom May to June 2011, fifty follow-up DTC patients were collected retrospectively 6 months or more after 131I ablation therapy following total-thyroidectomy or near-total thyroidectomy. The diagnostic standard for DTC metastasis and relapse were based on serum Tg, D-WBS, neck ultrasound and chest CT. Diagnostic 2 by 2 table was employed for calculating the sensitivity, specificity, accuracy of the methods. ResultsThe sensitivity, specificity, accuracy, positive predictive value, negative predictive value of TgIMA and D-WBS parallel experiments were 100.0%, 92.9%, 96.0%, 91.7%, and 100.0% respectively. ConclusionTgIMA combined with D-WBS parallel test in diagnosis of DTC metastasis and recurrence has the highest accuracy.
ObjectiveTo evaluate whether thyroglobin (Tg) value by radioimmunoassay (Tg-RIA) can be used as a complementary marker in differentiated thyroid cancer (DTC) patients, as serum Tg value is the key marker for the follow-up of patients with DTC, and endogenous antithyroglobulin (TgAb) interferes with serum Tg value by immunometric assay (Tg-IMA). MethodsFifty-five in-hospital patients with DTC after total thyroidectomy and 131I ablation during September and December 2012 were enrolled. Tg-IMA tests and Tg-RIA tests were performed separately. Diagnostic criteria about relapse, metastasis or disease-free status of thyroid carcinoma were established by serum Tg, diagnostic whole body scan (D-WBS), neck ultrasonography, chest CT and patients' history. ResultsTwo DTC patients showed false negative Tg-IMA and true positive Tg-RIA. Five patients had false negative Tg-RIA because of low sensitivity of RIA. Four patients with weak positive Tg-IMA (1.07-4.09 μg/L) required follow-up. Among the 11 DTC patients with strong TgAb positivity (>115 kU/L), two patients with positive Tg-IMA and positive Tg-RIA received second operation or radioiodine therapy, seven patients had positive Tg-RIA and negative Tg-IMA. Five of the seven patients with strong positive TgAb needed further follow-up, and two of them received radioiodine therapy. ConclusionTg value with radioimmunoassay is a complementary marker to find false negative Tg-IMA in follow-up patients with DTC.