Abstract：
OBJECTIVE: The aim of this study was to evaluate the clinical value of preoperative thyroid autoantibodies with reference to the post-thyroidectomy patient pathology.
METHODS: A retrospective cohort study.
METHODS: Two tertiary care academic hospitals.
METHODS: A total of (n = 473) subjects who underwent thyroidectomy from 2009 to 2019 were included. Preoperative serum thyroid autoantibodies (anti-thyroglobulin [anti-Tg] and anti-thyroperoxidase [anti-TPO]) were measured, and the potential predictors of postoperative pathological diagnosis (age, gender, and thyroid autoantibodies) were assessed using multivariable regression models.
RESULTS: Patients with positive thyroid autoantibodies were more likely to have malignant disease than benign disease; adjusted odds ratio (AOR) = 1.6 (1.3-2.7, p = 0.002) for anti-Tg, and AOR = 1.6 (1.1-2.5, p = 0.027) for anti-TPO. A subset analysis of the same predictors performed on patients with cancer (malignant vs. microcarcinoma) showed that patients with ages ≥40 were more likely to develop microcarcinoma as opposed to malignant disease; AOR = 1.8 (1.1-3.1, p = 0.03) for anti-TPO, and AOR = 1.7 (1.0-2.9, p = 0.04) for anti-Tg.
CONCLUSIONS: Preoperative thyroid autoantibodies could be used clinically to predict the risk of malignancy in thyroid nodules, thus helping guide treatment decisions in patients with thyroid nodules and speeding up the decision to undergo surgical intervention.
METHODS: A retrospective cohort study.
METHODS: Two tertiary care academic hospitals.
METHODS: A total of (n = 473) subjects who underwent thyroidectomy from 2009 to 2019 were included. Preoperative serum thyroid autoantibodies (anti-thyroglobulin [anti-Tg] and anti-thyroperoxidase [anti-TPO]) were measured, and the potential predictors of postoperative pathological diagnosis (age, gender, and thyroid autoantibodies) were assessed using multivariable regression models.
RESULTS: Patients with positive thyroid autoantibodies were more likely to have malignant disease than benign disease; adjusted odds ratio (AOR) = 1.6 (1.3-2.7, p = 0.002) for anti-Tg, and AOR = 1.6 (1.1-2.5, p = 0.027) for anti-TPO. A subset analysis of the same predictors performed on patients with cancer (malignant vs. microcarcinoma) showed that patients with ages ≥40 were more likely to develop microcarcinoma as opposed to malignant disease; AOR = 1.8 (1.1-3.1, p = 0.03) for anti-TPO, and AOR = 1.7 (1.0-2.9, p = 0.04) for anti-Tg.
CONCLUSIONS: Preoperative thyroid autoantibodies could be used clinically to predict the risk of malignancy in thyroid nodules, thus helping guide treatment decisions in patients with thyroid nodules and speeding up the decision to undergo surgical intervention.
摘要：
目的：本研究的目的是参考甲状腺切除术后患者的病理，评估术前甲状腺自身抗体的临床价值。
方法：回顾性队列研究。
方法：两所三级护理学术医院。
方法：纳入2009年至2019年接受甲状腺切除术的受试者（n=473）。术前测量血清甲状腺自身抗体（抗甲状腺球蛋白[抗Tg]和抗甲状腺过氧化物酶[抗TPO]），以及术后病理诊断的潜在预测因素(年龄，性别,和甲状腺自身抗体）使用多变量回归模型进行评估。
结果：甲状腺自身抗体阳性的患者比良性疾病更可能患有恶性疾病；抗Tg的校正比值比（AOR）=1.6（1.3-2.7，p=0.002），抗TPO的AOR=1.6(1.1-2.5,p=0.027)。对癌症患者进行的相同预测因子的子集分析(恶性与恶性微癌）表明，年龄≥40岁的患者比恶性疾病更容易发生微癌；抗TPO的AOR=1.8（1.1-3.1，p=0.03），对于反Tg,AOR=1.7(1.0-2.9,p=0.04)。
结论：术前甲状腺自身抗体可用于临床预测甲状腺结节的恶性风险，从而帮助指导甲状腺结节患者的治疗决策，并加快接受手术干预的决策。
方法：回顾性队列研究。
方法：两所三级护理学术医院。
方法：纳入2009年至2019年接受甲状腺切除术的受试者（n=473）。术前测量血清甲状腺自身抗体（抗甲状腺球蛋白[抗Tg]和抗甲状腺过氧化物酶[抗TPO]），以及术后病理诊断的潜在预测因素(年龄，性别,和甲状腺自身抗体）使用多变量回归模型进行评估。
结果：甲状腺自身抗体阳性的患者比良性疾病更可能患有恶性疾病；抗Tg的校正比值比（AOR）=1.6（1.3-2.7，p=0.002），抗TPO的AOR=1.6(1.1-2.5,p=0.027)。对癌症患者进行的相同预测因子的子集分析(恶性与恶性微癌）表明，年龄≥40岁的患者比恶性疾病更容易发生微癌；抗TPO的AOR=1.8（1.1-3.1，p=0.03），对于反Tg,AOR=1.7(1.0-2.9,p=0.04)。
结论：术前甲状腺自身抗体可用于临床预测甲状腺结节的恶性风险，从而帮助指导甲状腺结节患者的治疗决策，并加快接受手术干预的决策。
