Abstract: Objective To explore the predictive value of serum follistatin （FS） combined with thyroglobulin for the radical postoperative recurrence of thyroid cancer. Methods 95 patients in Shaowu Municipal Hospital from July 2017 to December 2019 were selected as recurrence for 3 years （n=32） and no recurrence （n=63）, compared serum FS level and thyroglobulin level, drew serum FS and thyroglobulin prediction ROC curve for postoperative recurrence of thyroid cancer, calculated AUC and combined detection for postoperative recurrence of thyroid cancer, and evaluated the risk factors for radical recurrence of thyroid cancer. Results The serum FS level and thyroglobulin level in the relapse group were significantly higher than those in the no-relapse group （P<0.05）. The AUC of serum FS after radical thyroid cancer was 0.8333 （95%CI： 0.7438-0.9229, P<0.0001）, AUC of CRC was 0.8350 （95%CI： 0.7380-0.9319, P<0.0001）, serum FS for thyroid cancer was 0.9150 （95%CI： 0.8458-0.9842, P<0.0001）. The optimal post-radical recurrence cutoff value of serum FS was 3.38 ng/mL, with prediction sensitivity of 78.79% and 78.13% specificity. The optimal cut-off value of thyroglobulin for postoperative recurrence of thyroid cancer was 217.46 ng/mL, the prediction sensitivity was 75.00% and the specificity was 75.00%. The prediction sensitivity of thyroglobulin and serum FS was 84.38% and 81.25%; the combined test was slightly better than that of thyroglobulin and serum FS alone. Multivariate Logistic regression analysis showed that FS and thyroglobulin were independent risk factors for the recurrence of radical thyroid cancer resection （P<0.05）. Conclusion The serum FS and thyroglobulin levels of patients with recurrence after radical resection of thyroid cancer will increase significantly, and the above indicators have good predictive value for recurrence after radical resection of thyroid cancer, which can be considered in the prognosis evaluation of such patients.

Key words: Follosin, thyroglobulin, radical thyroid cancer, recurrence predictive value, combined test

摘要： 目的 探究血清卵泡抑素（FS）联合甲状腺球蛋白对甲状腺癌根治性术后复发的预测价值。方法 选择2017年7月至2019年12月于邵武市立医院接受甲状腺癌根治术术后复发的32例患者作为研究对象,另选择63例有详细随访资料的未复发患者入组,按照随访3年结果分为复发组（n=32）和无复发组（n=63）,将患者血清FS水平及甲状球蛋白水平进行比较,并分别绘制血清FS和甲状腺球蛋白对甲状腺癌根治术后复发的预测ROC曲线,计算其AUC,计算联合检测对甲状腺癌术后复发预测价值,并评估甲状腺癌根治术复发危险因素。结果 复发组患者的血清FS水平以及甲状腺球蛋白水平均明显高于无复发组患者（P<0.05）;血清FS对甲状腺癌根治术后复发预测AUC为0.8333（95%CI：0.7438~0.9229,P<0.0001）;甲状腺球蛋白对甲状腺癌根治术后复发预测AUC为0.8350（95%CI：0.7380~0.9319,P<0.0001）;血清FS与甲状腺球蛋白联合对甲状腺癌根治术后复发预测AUC为0.9150（95%CI：0.8458~0.9842,P<0.0001）;血清FS判断甲状腺癌根治术后复发的最佳截断值为3.38 ng/mL,预测敏感度为78.79%、特异度为78.13%;甲状腺球蛋白判断甲状腺癌根治术后复发的最佳截断值为217.46 ng/mL,预测敏感度为75.00%、特异度为75.00%,甲状腺球蛋白与血清FS联合检测对甲状腺癌根治术后复发预测敏感度为84.38%、特异度为81.25%;联合检测稍优于甲状腺球蛋白与血清FS单独检测。多因素Logistic回归分析显示,FS、甲状腺球蛋白为甲状腺癌根治术复发独立危险因素（P<0.05）。结论 甲状腺癌根治术后出现复发患者其血清FS和甲状腺球蛋白水平会出现明显升高,而上述指标对甲状腺癌根治术后复发均具有较好的预测价值,可以考虑将其应用于此类患者的预后评估中。

关键词: 卵泡素, 甲状腺球蛋白, 甲状腺癌根治术, 复发预测价值, 联合检测