血清MK和Gal-3水平在甲状腺结节及DTC术后转移灶中的诊断价值  

Diagnostic value of serum MK and Gal-3 in thyroid nodules and postoperative DTC metastases

作　　者：武晨 杜芬 刘师伟 马浩华 张海涛 刘静[5] 张迎伟[6] 罗丽萍 程艳[1,7] Wu Chen;Du Fen;Liu Shiwei;Ma Haohua;Zhang Haitao;Liu Jing;Zhang Yingwei;Luo Liping;Cheng Yan(Department of Nuclear Medicine,the First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Nuclear Medicine,Cancer Hospital Chinese Academy of Medical Sciences,Shenzhen Center,Shenzhen 518116,China;Department of Endocrinology,Shanxi Bethune Hospital(Shanxi Academy of Medical Sciences),Taiyuan 030001,China;Central Laboratory of Taiyuan Central Hospital,Taiyuan 030001,China;Department of General Surgery,the First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Clinical Laboratory,the First Hospital of Shanxi Medical University,Taiyuan 030001,China;Molecular Imaging Precision Medicine Collaborative Innovation Center of Shanxi Province,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院核医学科,太原030001 [2]中国医学科学院肿瘤医院深圳医院核医学科,518116 [3]山西白求恩医院(山西医学科学院)内分泌科,太原030001 [4]太原市中心医院中心实验室,030001 [5]山西医科大学第一医院普外科,太原030001 [6]山西医科大学第一医院检验科,太原030001 [7]山西省分子影像精准诊疗协同创新中心,太原030001

出　　处：《国际放射医学核医学杂志》2020年第9期561-568,共8页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：山西省自然科学基金(201801D121233)。

摘　　要：目的探讨血清midkine(MK)和galectine-3(Gal-3)水平在良恶性甲状腺结节鉴别诊断中的价值,及其在分化型甲状腺癌(DTC)术后患者首次131I治疗前转移灶中的评估价值。方法①甲状腺结节鉴别诊断的回顾性研究:收集2016年11月至2017年11月在山西医科大学第一医院拟行手术治疗的41例甲状腺结节患者[男性11例、女性30例,年龄29~73(48.61±11.59)岁]的术前血清样本,根据病理结果分为恶性组(23例)和良性组(18例),同时收集32名健康者作为健康对照组。采用单因素方差分析术前血清MK和Gal-3水平在良恶性甲状腺结节中是否存在差异,并绘制受试者工作特征曲线分析两者对甲状腺结节的诊断价值。②DTC患者术后是否存在转移灶的回顾性研究:收集2016年11月至2017年11月于山西医科大学第一医院核医学科首次服131I治疗前的51例DTC术后患者[男性12例、女性39例,年龄25~72(44.41±10.21)岁]的血清样本及临床资料,所有患者行2次131I治疗,并于每次治疗后5~7 d行全身碘扫描,根据其结果及其他检查(超声、CT、PET/CT)结果,判断是否有淋巴结和(或)肺转移。采用两独立样本t检验比较组间血清MK和Gal-3水平的差异性,Pearson检验分析血清MK和Gal-3水平间的相关性。结果①手术前恶性组的血清MK和Gal-3水平明显高于良性组及健康对照组,且差异有统计学意义(F=48.40、5.08,均P<0.05)。对于术前良恶性甲状腺结节的鉴别,MK的最佳阈值为318.87 pg/mL、曲线下面积(AUC)为0.91(95%CI:0.81~0.99)、特异度为78.1%、灵敏度为88.5%;Gal-3的最佳阈值为1.61 ng/mL、AUC为0.72(95%CI:0.57~0.86)、特异度为70.4%、灵敏度为69.8%。②51例DTC患者中,转移阳性组8例、转移阴性组43例。转移阳性组甲状腺球蛋白、MK、Gal-3水平均明显高于转移阴性组,且差异有统计学意义(t=−4.86、−4.01、−2.89,均P<0.05)。Pearson相关性分析结果显示,甲状腺结节患者术前(r=0.67,P<0.05)及Objective To investigate the value of serum midkine(MK)and galectine-3(Gal3)in the differential diagnosis of benign and malignant thyroid nodules,and to analyze the ability of serum MK and Gal-3 to evaluate metastases before the first 131I treatment in patients with differentiated thyroid cancer(DTC)after thyroidectomy.Methods①Data on benign and malignant thyroid nodule differential diagnosis were collected from November 2016 to November 2017 in the First Hospital of Shanxi Medical University.In general surgery,41 cases(11 males and 30 females,aged 29−73(48.61±11.59)years)of surgical treatment of thyroid nodules in patients with preoperative blood specimens were determined.The patients were divided according to the result of pathology as follows:malignant group(23 cases)and benign group(18 cases).A total of 32 healthy subjects served as controls.One-way ANOVA was used to analyze whether preoperative serum MK and Gal-3 were different in benign and malignant thyroid nodules.Receiver operating characteristic curve was drawn to study the diagnostic value of the two in thyroid nodules.②From November 2016 to November 2017,51 patients(12 males and 39 females,aged 25−72(44.41±10.21)years)with DTC before the first 131I treatment in the Nuclear Medicine Department of the First Hospital of Shanxi Medical University participated in the evaluation of postoperative metastasis.All patients underwent 131I treatment two times,and the whole body iodine scan was performed 5−7 days after each treatment.According to the results and other examination results(ultrasound,CT,PET/CT),the lymph node and/or lung metastasis was judged.Serum was collected before the first iodine treatment.The differences in MK and Gal-3 between groups were compared using two-sample t-test.Pearson test was used to analyze the correlation between serum MK and Gal-3.before the first iodine treatment.The differences in MK and Gal-3 between groups were compared using two-sample t-test.Pearson test was used to analyze the correlation between serum MK an

关 键 词：甲状腺结节 甲状腺肿瘤 肿瘤转移 血清midkine 血清galectine-3 

分 类 号：R736.1[医药卫生—肿瘤]