血清NDRG3与甲状腺功能指标联合检测对甲状腺乳头状癌的诊断价值  

Diagnostic value of serum NDRG3 combined with thyroid function indexes in papillary thyroid carcinoma

作　　者：孟小玉 柴婷婷 MENG Xiaoyu;CHAI Tingting(Department of Surgery,Tongchuan People's Hospital,Tongchuan,Shaanxi 727100,China)

机构地区：[1]陕西省铜川市人民医院外科,陕西铜川727100

出　　处：《检验医学与临床》2023年第22期3344-3348,共5页Laboratory Medicine and Clinic

摘　　要：目的探讨血清N-myc下游调控基因3(NDRG3)与甲状腺功能指标联合检测诊断甲状腺乳头状癌的效能。方法选取2021年5月至2022年5月在该院收治的甲状腺乳头状癌患者115例作为甲状腺癌组,选取同期在该院进行诊治的甲状腺良性结节患者115例作为良性对照组。检测并比较两组血清及甲状腺乳头状癌组织NDRG3水平,检测两组甲状腺过氧化物酶抗体(TpoAb)、甲状腺球蛋白抗体(TgAb)、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平等甲状腺功能指标,并计算FT4/FT3比值。采用多因素Logistic回归分析甲状腺乳头状癌发生的影响因素;采用受试者工作特征(ROC)曲线分析血清NDRG3与甲状腺功能指标联合检测对甲状腺乳头状癌的诊断效能。结果甲状腺癌组血清TpoAb、TgAb、TSH、FT4/FT3水平均明显高于良性对照组,NDRG3、FT3水平明显低于良性对照组,差异有统计学意义(P<0.05)。NDRG3在甲状腺乳头状癌组织中阳性表达率为36.52%(42/115),明显低于甲状腺良性结节中的阳性表达率[73.91%(85/115)],差异有统计学意义(χ2=32.511,P<0.001)。多因素Logistic回归分析结果显示,血清TSH≥2.58 mIU/L、FT4/FT3≥3.32为甲状腺乳头状癌发生的独立危险因素(P<0.05),血清NDRG3≥432.89 pg/mg、FT3≥4.47 pmol/L为甲状腺乳头状癌发生的独立保护因素(P<0.05)。血清NDRG3、TSH、FT3、FT4/FT3单独及联合检测的曲线下面积(AUC)分别为0.838、0.766、0.692、0.713、0.906,4项指标联合检测诊断甲状腺乳头状癌的AUC明显大于单项指标检测。存在甲状腺外延伸、淋巴结转移及TNM分期Ⅲ~Ⅳ期的甲状腺乳头状癌患者NDRG3水平明显低于不存在甲状腺外延伸、淋巴结转移及TNM分期Ⅰ~Ⅱ期的状腺乳头状癌患者,差异有统计学意义(P<0.05)。结论甲状腺乳头状癌患者血清NDRG3与甲状腺功能指标呈现异常表达,各项指标可能参与了肿瘤的起源或进展,联�Objective To investigate the efficacy of serum N-myc downstream regulatory gene 3(NDRG3)combined with thyroid function indexes in the diagnosis of papillary thyroid carcinoma.Methods A total of 115 cases of papillary thyroid carcinoma admitted to Tongchuan People's Hospital from May 2021 to May 2022 were selected as thyroid cancer group,and 115 cases of benign thyroid nodules treated in this hospital during the same period were selected as benign control group.The levels of NDRG3 in serum and papillary thyroid carcinoma tissues of the two groups were detected and compared.Thyroid peroxidase antibody(Tpo-Ab),thyroglobulin antibody(TgAb),thyrotropin(TSH),free triiodothyronine(FT3),free thyroxine(FT4),and other thyroid function indexes were detected in the two groups,and calculated the FT4/FT3 ratio.Multiple Logistic regression was used to analyze the influencing factors for the occurrence of papillary thyroid carcinoma.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic efficacy of serum NDRG3 combined with thyroid function indexes in papillary thyroid carcinoma.Results The serum levels of TpoAb,TgAb,TSH and FT4/FT3 in thyroid cancer group were significantly higher than those in benign control group,and the levels of NDRG3 and FT3 were significantly lower than those in benign control group,with statistical significance(P<0.05).The positive expression rate of NDRG3 in thyroid papillary carcinoma was 36.52%(42/115),which was significantly lower than that in benign thyroid nodules[73.91%(85/115)],the difference was statistically significant(χ2=32.511,P<0.001).Multiple Logistic regression analysis showed that the serum TSH level≥2.58 mIU/L and FT4/FT3 level≥3.32 were independent risk factors for the ccurrence of papillary thyroid carcinoma(P<0.05),and the serum NDRG3 level≥432.89 pg/mg and FT3 level≥4.47 pmol/L were independent protective factors for the occurrence of papillary thyroid carcinoma(P<0.05).The areas under the curve(AUC)of serum NDRG3,TSH,FT3,FT4/FT3 were 0.838,0.766,0.6

关 键 词：N-myc下游调控基因3 甲状腺功能 甲状腺乳头状癌 

分 类 号：R446.9[医药卫生—诊断学]