中期因子、胰岛素样生长因子-1和甲状腺球蛋白在分化型甲状腺腺癌中的诊断与预后价值  

Diagnostic and prognostic value of midkine,insulin-like growth factor-1 and thyroglobulin in differentiated thyroid adenocarcinoma

作　　者：田陶然 于海文 沈琦 邱炜庆 沈华 TIAN Taoran;YU Haiwen;SHEN Qi(Department of General Surgery, Nanxiang Hospital of Jiading District, Shanghai 201802,China)

机构地区：[1]上海市嘉定区南翔医院普外科

出　　处：《河北医药》2020年第1期15-18,23,共5页Hebei Medical Journal

摘　　要：目的研究联合检测中期因子(MK)、胰岛素样生长因子-1(IGF-1)和甲状腺球蛋白(Tg)在分化型甲状腺腺癌中的诊断和预后价值。方法选择确诊为分化型甲状腺腺癌患者98例为甲状腺腺癌组,选择同期确诊为甲状腺腺瘤(65例)和健康体检者(30例)为甲状腺腺瘤组和健康对照组。观察3组血清MK、IGF-1和Tg水平变化,甲状腺腺癌患者血清MK、IGF-1和Tg水平与肿瘤分期和预后的关系,联合检测在诊断甲状腺腺癌和预后的灵敏度和特异性。结果甲状腺腺癌组的血清MK、IGF-1和Tg水平明显高于甲状腺腺瘤组和健康对照组,甲状腺腺瘤组明显高于健康对照组,并且随着肿瘤分期升高而升高(P<0.01)。在鉴别良恶性甲状腺方面,联合检测MK、IGF-1和Tg的灵敏度为86.7%,特异性92.3%,其曲线下面积为0.953,在诊断甲状腺腺癌方面其曲线下面积较单个指标MK、IGF-1和Tg更为显著,其效能明显提高。甲状腺癌患者预后不良患者血清MK、IGF-1和Tg水平明显高于预后良好患者(P<0.01),在诊断预后不良方面联合检测MK、IGF-1和Tg的灵敏度为97.4%,特异性84.7%,其曲线下面积为0.961,其曲线下面积较单个指标MK、IGF-1和Tg更为显著(P<0.05)。结论联合检测MK、IGF-1和Tg水平有助于诊断分化型甲状腺腺癌,并且对甲状腺腺癌预后的判断具有重要临床价值,明显优于单个指标的检测。Objective To investigate the diagnostic and prognostic value of combination detection of midkine(MK),insulin-like growth factor-1(IGF-1)and thyroglobulin(Tg)in differentiated thyroid adenocarcinoma.Methods A total of 98 patients with differentiated thyroid adenocarcinoma,who were diagnosed in our hospital from January 2016 to June 2018,were enrolled as thyroid adenocarcinoma group,at the same time,the other 65 patients with thyroid adenoma were enrolled as thyroid adenoma group,moreover,30 healthy subjects were enrolled as control group.The changes of serum levels of MK,IGF-1 and Tg were observed,and the correlation between the changes of serum levels of MK,IGF-1,Tg and tumor staging as well as patient’s prognosis was analyzed.In addition the sensitivity and specificity of combination detection in diagnosis of thyroid adenocarcinoma and prognosis evaluation were analyzed.Results The serum levels of MK,IGF-1 and Tg in thyroid adenocarcinoma group were significantly higher than those in thyroid adenoma group and control group,which in thyroid adenoma group were significantly higher than those in control group(P<0.01).In the differential diagnosis between benign and malignant thyroid tumors,the sensitivity of combination detection of MK,IGF-1 and Tg was 86.7%,the specificity was 92.3%,and the area under curve was 0.953.The area under curve of combination detection in diagnosis of thyroid adenocarcinoma was more significant than that by simple MK(Z=4.110,P<0.01),IGF-1(Z=3.824,P<0.01)and Tg(Z=4.597,P<0.01),and the diagnostic efficacy was significantly improved.The serum levels of MK,IGF-1 and Tg in patients with poor prognosis were significantly higher than those of patients with good prognosis(P<0.01).In the diagnosis of poor prognosis of patients,the sensitivity of combination detection of MK,IGF-1 and Tg was 97.4%,the specificity was 84.7%,and the area under curve was 0.961.The area under curve of combination detection was more significant than that by simple MK(Z=2.470,P<0.05),IGF-1(Z=3.478,P<0.01)and Tg(Z=2.978

关 键 词：甲状腺癌 早期诊断 中期因子 胰岛素样生长因子-1 甲状腺球蛋白 

分 类 号：R736.1[医药卫生—肿瘤]