超声弹性成像检查联合BRAF V600E和TSGF检测对甲状腺癌的诊断价值  

The value of ultrasound elastography combined with BRAF VV600EE and TSGF in differential diagnosis of thyroid cancer

作　　者：赵丽娜[1] 张雪松[1] 李晶[1] ZHAO Lina;ZHANG Xuesong;LI Jing(Department of Medical Ultrasonics,the First Affiliated Hospital,Heilongjiang University of Chinese Medicine,Harbin 150040,Heilongjiang,China)

机构地区：[1]黑龙江中医药大学附属第一医院超声医学科

出　　处：《癌症进展》2019年第24期2910-2913,共4页Oncology Progress

摘　　要：目的探讨超声弹性成像(UE)联合丝/苏氨酸特异性激酶基因(BRAF)V600E突变、血清肿瘤特异性生长因子(TSGF)检测对甲状腺癌的诊断价值。方法根据病理检查结果将128例甲状腺结节患者分为甲状腺癌组(n=60)和甲状腺良性病变组(n=68),另选择同期80例健康体检者作为对照组。3组研究对象均给予常规超声和UE检查及BRAF V600E和血清TSGF检测。分析甲状腺良性结节和恶性结节的常规超声特征,比较甲状腺癌组、甲状腺良性病变组和对照组的BRAF V600E基因突变率和血清TSGF水平。以病理诊断结果为金标准,分析UE、BRAF V600E、TSGF单独及联合检测对甲状腺癌的诊断价值。结果甲状腺良性结节和恶性结节的边界、形态、纵横比、内部回声、钙化、周边声晕、后方回声衰减、淋巴结转移情况比较,差异均有统计学意义(P﹤0.01)。甲状腺癌组患者的BRAF V600E基因突变率和血清TSGF水平均高于甲状腺良性病变组和对照组,甲状腺良性病变组患者的BRAF V600E基因突变率和血清TSGF水平均高于对照组,差异均有统计学意义(P﹤0.05)。UE+BRAF V600E+TSGF联合诊断甲状腺癌的灵敏度、特异度、准确度、阳性预测值和阴性预测值均高于任一方法单独诊断的结果(P﹤0.05)。结论UE检查联合BRAF V600E和TSGF检测可提高甲状腺癌的诊断准确性,值得临床推广应用。Objective To investigate the value of ultrasound elastography(UE)combined with serine-threonine protein kinase(BRAF)V600E mutation and serum tumor specific growth factor(TSGF)detection in differential diagnosis of thyroid cancer.Method A total of 128 patients with thyroid nodules were included in the study and categorized to thyroid cancer group(n=60)and benign thyroid disease group(n=68)according to the pathological findings,meanwhile,another 80 volunteers with normal thyroid tissue were enrolled as control group.All groups of subjects were examined by conventional ultrasound,UE and BRAF V600E mutation and serum TSGF were detected.The conventional ultrasound findings of benign and malignant thyroid nodules were analyzed and compared,the mutation rate of BRAF V600E and serum TSGF level in thyroid cancer group,benign thyroid disease group and control group were compared.The diagnostic value of UE,BRAF V600E and TSGF alone or in combination for diagnosing thyroid cancer were determined.Result Between the benign and malignant thyroid nodules,significant differences were noted regarding the boundary,morphology,aspect ratio,internal echo,calcification,peripheral halo,posterior echo attenuation,and lymph node metastases(P<0.01).The mutation rate of BRAF V600E and serum TSGF level of thyroid cancer group were significantly higher than that of benign thyroid disease group and control group,and those in benign thyroid disease group were evidently higher compared to control group(P<0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the combined detection involving UE+BRAF V600E+TSGF was significantly higher than that of each technique utilized alone(P<0.05).Conclusion Detection of UE combined with BRAF V600E mutation and serum TSGF can improve the accuracy of thyroid cancer diagnosis.

关 键 词：超声弹性成像 甲状腺癌 甲状腺良性病变 BRAF V600E基因 肿瘤特异性生长因子 病理诊断 

分 类 号：R736.1[医药卫生—肿瘤]