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目的:探究儿童及青少年分化型甲状腺癌(DTC)患者术后n 131I治疗前刺激性甲状腺球蛋白(ps-Tg)水平对远处转移的预测价值。n 方法:回顾性分析2016年1月至2020年3月间就诊于北京协和医院的54例甲状腺全切术后的DTC患者，依据是否存在远处转移分为M0组[29例，男10例，女19例，年龄(16.3±3.8)岁]及M1组[25例，男13例，女12例，年龄(12.4±4.3)岁]。用两独立样本n t检验、n χ2检验(或Fisher确切概率法)及Mann-Whitney n U检验分析2组间的一般特征差异。依据n 131I治疗时是否合并局部淋巴结(RLN)转移进一步分为M1RLN+(n n＝8)、M1RLN-(n n＝17)及M0RLN+(n n＝5)、M0RLN-(n n＝24)组；采用Mann-Whitney n U检验分析M1与M0组间、M1RLN+与M1RLN-组间、M0RLN+与M0RLN-组间ps-Tg的差异。建立受试者工作特征(ROC)曲线，获得最佳诊断界值点。n 结果:与M0组相比，M1组ps-Tg水平更高(中位数：406.80 μg/L与7.90 μg/L；n U＝690.000，n P0.05)，但各RLN+组的中位ps-Tg均有高于RLN-组的趋势(18.05与5.71 μg/L；1 698.50与216.40 μg/L)。为去除RLN对ps-Tg预测界值的影响，剔除13例RLN+病例，获得的反映ps-Tg与DTC单纯远处转移之间关系的ROC曲线下面积为0.946(95%n CI：0.883～1.000)，当ps-Tg界值点为55.87 μg/L时，区分M0RLN-与M1RLN-的灵敏度为14/17，特异性为95.8%(23/24)。n 结论:Ps-Tg有助于识别儿童DTC远处转移，可辅助判断n 131I治疗前不明确的影像学结果，避免部分远处转移DTC患者可能的n 131I治疗不足问题。n “,”Objective:To explore the value of preablative stimulated thyroglobulin (ps-Tg) in predicting distant metastasis (DM) at the time of n 131I therapy in children and adolescents with differentiated thyroid cancer (DTC).n Methods:From January 2016 to March 2020, 54 children and adolescents who underwent total thyroidectomy due to DTC in Peking Union Medical College Hospital were retrospectively reviewed and divided into 2 groups according to the presence of DM or not: M0 group(n n=29, 10 males, 19 females, age (16.3±3.8) years) and M1 group(n n=25, 13 males, 12 females, age (12.4±4.3) years). Independent-sample n t test, n χ2 test (or Fisher′s exact test) and Mann-Whitney n U test were used to analyze the general characteristics between the two groups. According to status of regional lymph node (RLN) at the time of n 131I therapy, the two groups were further divided into M1RLN+ (n n=8) and M1RLN-(n n=17), M0RLN+ (n n=5) and M0RLN-(n n=24) subgroups. Mann-Whitney n U test was used to analyze the different ps-Tg levels between M0 and M1, M1RLN+ and M1RLN-, as well as M0RLN+ and M0RLN-groups. The receiver operating characteristic (ROC) curve analysis was employed to obtain a cut-off value of ps-Tg as a predictor of DM.n Results:Patients with DM tended to have higher ps-Tg level (medians: 406.80 μg/L n vs 7.90 μg/L, n U=690.000, n P0.05) or between M0RLN+ group and M0RLN-group (n U=63.000, n P>0.05), the two RLN+ groups tended to hold higher medians than the two RLN-groups (18.05n vs 5.71 μg/L; 1 698.50 n vs 216.40 μg/L). In order to avoid the possible influence on the ps-Tg cut-off value, 13 RLN+ samples were removed, and the area under the ROC curve was 0.946 (95% n CI: 0.883-1.000). The ps-Tg level of 55.87 μg/L was established as the optimal cut-off value to distinguish M0RLN- from M1RLN-, with the sensitivity and specificity of 14/17 and 95.8%(23/24), respectively.n Conclusion:Ps-Tg holds a high predictive value in identifying DM, which may be of great help in avoiding inadequate n 131I treatment in children and adolescents with metastatic DTC ignored by radiological examinations.n