关键词:

甲状腺相关激素水平, 甲状腺单侧腺叶切除术, 疗效评估, 预后

Abstract:

Objective The aim of this study was to explore the effect of changes in thyroid⁃related hormone levels on the evaluation of curative effect and prognostic value analysis of subtotal thyroidectomy. Methods A total of 325 patients with differentiated thyroid cancer（DTC）were selected as the research object. The patients were treated with unilateral thyroidectomy. The levels of thyroid related hormones before operation and 1，2，4，5 and 7 days after operation were compared. According to the recurrence of two years after operation，the patients were divided into recurrence group（n = 21）and non recurrence group（n = 304）. The factors affecting postoperative recurrence were analyzed by multivariate logistic regression. Receiver operating characteristic curve（ROC）was used to evaluate the predictive value of thyroid related hormone levels for postoperative recurrence. According to the cut⁃off value obtained by X⁃tile software，the patients were divided into low⁃risk group，medium risk group and high⁃risk group，and their prediction efficiency was evaluated；Kaplan Meier method was used to draw the survival curve and compare the postoperative recurrence of patients with different recurrence risks. Results The total effec⁃ tive rate of 325 patients was 95.08%. The levels of T3，FT3，T4 and FT4 in the effective group and the effective group were significantly lower than those before operation，and the level of TSH was significantly higher than that before operation，while the level of thyroid related hormones in the ineffective group did not change significantly （P < 0.05）. Multivariate analysis showed that metastasis，tumor stage Ⅲ + Ⅳ，low differentiation，T3 and T4 were independent risk factors for postoperative recurrence of DTC patients（P < 0.05），and TSH was protective factor（P < 0.05）. ROC curve shows that thyroid related hormone level has high predictive value for postoperative recurrence in patients with DTC. The risk scoring model has good discrimination and effectiveness；The results of survival curve showed that the postoperative recurrence rate in high⁃risk group was significantly higher than that in low⁃risk group and medium⁃risk group（P < 0.001）. Conclusion Thyroid⁃related hormone levels in DTC patients remained dynamic after subtotal thyroidectomy，which could be used as an effective index to evaluate the efficacy of surgery，and had a certain predictive value for the patient′s recurrence.

Key words:

thyroid?related hormone levels, subtotal thyroidectomy, efficacy evaluation, prognosis