超声造影及TgAb、SP1和KLF4表达水平对分化型甲状腺癌临床分期的诊断价值  

Relationship Between Malignant Degree of Differentiated Thyroid Carcinoma and Contrast-enhanced Ultrasound Parameters and Serum TgAb,SP1 and KLF4

作　　者：张文涛 董汉华[1] 赵亚鹏 康志强[1] ZHANG Wentao;DONG Hanhua;ZHAO Yapeng(Zhengzhou Central Hospital,Zhengzhou,450000)

机构地区：[1]河南省郑州市中心医院,450000

出　　处：《实用癌症杂志》2024年第5期701-704,709,共5页The Practical Journal of Cancer

基　　金：2019年河南省医学科技攻关计划联合共建项目(编号:LHGJ20191040)。

摘　　要：目的探讨超声造影及血清甲状腺球蛋白抗体(TgAb)、特异性蛋白1(SP1)和Krüppel样因子4(KLF4)基因表达对分化型甲状腺癌(DTC)的诊断价值,并分析其相关性。方法采用便利抽样法选取手术治疗的130例DTC患者为研究对象,术前使用彩色多普勒超声诊断仪进行甲状腺检查,记录超声造影参数造影剂达峰时间(TIP)、平均通过时间(MTT)以及峰值强度(PI)。术前采集患者晨起空腹静脉血,检测血清TgAb、SP1和KLF4水平。收集患者术后病理标本,根据AJCC分级系统对DTC临床分期进行评估,比较不同分期患者的超声造影参数与血清TgAb、SP1、KLF4表达水平的差异;采用Spearman法进行DTC临床分期与TIP、MTT、PI、TgAb、SP1、KLF4水平相关性分析;绘制受试者工作特征曲线(ROC)分析超声造影与血清TgAb、SP1、KLF4水平对DTC临床分期的诊断效能。结果Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期,DTC患者TIP、MTT、PI和KLF4 mRNA相对表达水平依次降低,血清TgAb水平和SP1mRNA相对表达水平依次升高(P<0.001)。DTC临床分期与TIP、MTT、PI和血清KLF4 mRNA水平负相关(P<0.05),与血清TgAb、SP1 mRNA水平正相关(P<0.05)。超声造影、TgAb水平、SP1与KLF4 mRNA表达水平单一及联合诊断DTC的AUC依次为0.808、0.715、0.689、0.667、0.853,其中联合诊断AUC最大。结论DTC临床分期与超声造影参数TIP、MTT、PI和血清KLF4表达呈负相关关系,与血清TgAb、SP1表达呈正相关关系,将超声造影与血清TgAb、SP1和KLF4联合用于鉴别诊断DTC临床分期的效能最高。Objective To evaluate the diagnostic value of contrast-enhanced ultrasonography(ceus)and the expression of serum thyroglobulin antibody(TgAb),specific protein 1(SP1)and KRüppel-like factor 4(KLF4)genes in differentiated thyroid carcinoma(DTC),and to analyze their correlation.Methods Convenient sampling method was used to select 130 DTC patients who underwent surgical treatment as the research object.The preoperative thyroid examination was performed with color Doppler ultrasound diagnostic apparatus before operation,and the ultrasound contrast parameters,such as time to peak(TIP),mean transit time(MTT),and peak intensity(PI)were recorded.Before operation,fasting venous blood was collected in the morning to detect the serum TgAb,SP1 and KLF4 levels.The clinical stages of DTC were evaluated according to AJCC grading system.The differences of contrast-enhanced ultrasound parameters and serum levels of TgAb,SP1 and KLF4 were compared Spearman method was used to analyze the correlation between DTC clinical stage and TIP,MTT,PI,TgAb,SP1,KLF4 levels The receiver operating characteristic curve(ROC)was drawn to analyze the diagnostic efficacy of contrast-enhanced ultrasonography and serum levels of TgAb,SP1 and KLF4 in DTC clinical staging.Results The relative expression levels of TIP,MTT,PI and KLF4 mRNA in patients with DTC in stages Ⅰ,Ⅱ,Ⅲ and Ⅳ decreased in turn,and the serum TgAb level and the relative expression level of SP1 mRNA increased in turn(P<0.001).The clinical stage of DTC was negatively correlated with TIP,MTT,PI and serum KLF4 mRNA levels(P<0.05),and positively correlated with serum TgAb and SP1 mRNA levels(P<0.05).AUC for single and combined diagnosis of DTC was 0.808,0.715,0.689,0.667 and 0.853 respectively,including contrast enhanced ultrasound,TgAb level,SP1 and KLF4 mRNA expression level,and AUC for combined diagnosis was the largest.Conclusion The clinical stage of DTC was negatively correlated with contrast-enhanced ultrasound parameters TIP,MTT,Pi and the expression of KLF4 in serum,and po

关 键 词：分化型甲状腺癌 临床分期 超声造影参数 甲状腺球蛋白抗体 特异性蛋白1 Krüppel样因子4 

分 类 号：R736.1[医药卫生—肿瘤]