Predictive Value of Combined Detection of Thyroid Peroxidase Antibody and Thyroid-Stimulating Hormone for Postoperative Treatment Effect in Patients with Thyroid Cancer

doi:10.16458/j.cnki.1007-0893.2025.20.018

Abstract：Objective: To explore the predictive value of combined detection of serum thyroid peroxidase antibody (TPOAb) and thyroid-stimulating hormone (TSH) for the therapeutic effect of sodium levothyroxine in patients with differentiated thyroid cancer (DTC) after surgery. Methods: A retrospective analysis was conducted on the clinical data of 122 DTC patients who underwent surgical treatment at Xinyang No. 154 Hospital, China Rongtong Healthcare Group Co., Ltd., from February 2020 to December 2022. All patients took sodium levothyroxine regularly after surgery and completed a 2-year follow-up. According to the follow-up results, patients who relapsed were classified into the recurrence group, while those who did not relapse were classified into the non-recurrence group. The differences in clinical data and levels of TPOAb and TSH between the two groups were compared. Multivariate logistic regression analysis was used to screen risk factors affecting the therapeutic effect of sodium levothyroxine after DTC surgery. The area under the receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of TPOAb, TSH alone, and their combination in predicting the therapeutic effect of sodium levothyroxine after DTC surgery. Results: After treatment with sodium levothyroxine, 26 out of 122 DTC patients experienced recurrence and were classified into the recurrence group, while 96 patients did not recur and were classified into the non-recurrence group. The proportion of T3/T4 stage was higher in the recurrence group, and the serum levels of TPOAb and TSH were significantly higher in the recurrence group compared to the non-recurrence group, with statistically significant differences (P < 0.05). Multivariate logistic regression analysis showed that T stage (T3/T4), elevated TPOAb, and elevated TSH levels were independent risk factors affecting the therapeutic effect of sodium levothyroxine after DTC surgery (P < 0.05). ROC curve analysis showed that the area under the curve (AUC) of combined detection of TPOAb and TSH was 0.911, with a sensitivity of 0.846, specificity of 0.865, and Younden index of 0.711. All indicators were better than those of either single detection alone. Conclusion: TPOAb and TSH are both effective indicators for predicting the therapeutic effect of sodium levothyroxine in DTC patients after surgery. Combined detection of the two can improve the accuracy of prediction and provide more sufficient data support for clinical individualized treatment planning and prognosis evaluation.