GIÁ TRỊ TIÊN LƯỢNG CỦA KÍCH THƯỚC TỔN THƯƠNG DI CĂN PHỔI TRÊN CẮT LỚP VI TÍNH VÀ NỒNG ĐỘ THYROGLOBULIN Ở BỆNH NHÂN UNG THƯ TUYẾN GIÁP BIỆT HÓA DI CĂN PHỔI

Abstract

Background: Thyroglobulin (Tg) levels and pulmonary metastasis size on computed tomography (CT) are routine indicators in the management of differentiated thyroid cancer (DTC) with pulmonary metastases. However, their optimal prognostic cut-offs for mortality in Vietnam remain unclear.

Subjects and Methods: A retrospective and prospective descriptive study was conducted on 165 DTC patients with lung metastases who underwent total thyroidectomy and I-131 therapy at the 108 Military Central Hospital from August 2004 to March 2026. Receiver Operating Characteristic (ROC) curve analysis, Area Under the Curve (AUC), and Youden's index were utilized to identify the optimal cut-offs for predicting mortality.

Results: The ROC curve for pre-treatment stimulated Tg (n=159) yielded an AUC of 0.686; the optimal cut-off was 207 ng/mL with a sensitivity of 88.46% and a specificity of 54.89%. CT lesion size (n=160) demonstrated a better prognostic value with an AUC of 0.799; the optimal cut-off was identified as 5 mm, yielding a sensitivity of 80.77% and a specificity of 74.63%.

Conclusion: CT lung metastasis size shows a good prognostic value (cut-off > 5 mm), whereas Tg levels provide a moderate early warning value (cut-off > 207 ng/mL). Combining these indicators assists clinicians in risk stratification and optimizing treatment protocols.