应变弹性成像联合血清半乳糖凝集素3、基质金属蛋白酶-9对甲状腺乳头状癌颈部淋巴结转移的预测价值  

Prediction Value of Strain Elastography Combined with Serum Galectin-3 and matrix metalloproteinase-9 in Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma

作　　者：冉明阳 赫铁军 唐婉 张红 崔建娇 RAN Ming-yang;HE Tie-jun;TANG Wan;ZHANG Hong;CUI Jian-jiao(Department of Ultrasound,The First Affiliated Hospital of Dalian Medical University,Dalian,Liaoning,116011,China;Department of Ultrasound,The Third Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning,121000,China;Department of General surgery and Thyroid and Breast,The Third Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning,121000,China;Department of Clinical Laboratory,The Third Affiliated Hospital of Jinzhou Medical University,Jinzhou,Liaoning,121000,China)

机构地区：[1]大连医科大学附属第一医院超声科,辽宁大连116011 [2]锦州医科大学附属第三医院超声科,辽宁锦州121000 [3]锦州医科大学附属第三医院普外甲乳科,辽宁锦州121000 [4]锦州医科大学附属第三医院检验科,辽宁锦州121000

出　　处：《现代生物医学进展》2024年第21期4086-4089,共4页Progress in Modern Biomedicine

基　　金：辽宁省教育厅自然科学基金项目(JYTJT20231147)。

摘　　要：目的:探讨应变弹性成像联合血清半乳糖凝集素3(Galectin-3)、基质金属蛋白酶-9(MMP-9)对甲状腺乳头状癌(PTC)颈部淋巴结转移的预测价值。方法:选取2020年1月至2023年12月在锦州医科大学附属第三医院首次行甲状腺手术并经病理证实为PTC的214例患者,根据术后病理结果将患者分为转移组(90例)和未转移组(124例)。术前进行应变弹性成像获得弹性应变率比值(SR),检测血清Galectin-3、MMP-9水平。构建多因素Logistic回归方程,确定PTC发生颈部淋巴结转移的影响因素。基于各独立危险因素绘制受试者工作特征曲线(ROC)评估各指标单独或联合对PTC发生颈部淋巴结转移的预测效能。结果:转移组SR和血清Galectin-3、MMP-9水平均高于未转移组(P<0.05)。多因素Logistic回归分析显示,肿瘤直径≥1 cm、微钙化、高SR、高Galectin-3、高MMP-9是PTC发生颈部淋巴结转移的危险因素(P<0.05)。SR、Galectin-3、MMP-9预测PTC发生颈部淋巴结转移的AUC分别为0.827、0.814、0.824,联合预测的AUC为0.949,高于单独预测。结论:伴颈部淋巴结转移的PTC患者应变弹性成像参数SR和血清Galectin-3、MMP-9水平均显著增高,联合SR和Galectin-3、MMP-9在PTC患者颈部淋巴结转移风险预测中具有更高的价值。Objective:To investigate the predictive value of strain elastography combined with serum Galectin-3 and matrix metalloproteinase-9(MMP-9)in cervical lymph node metastasis of papillary thyroid carcinoma(PTC).Methods:A total of 214 patients who underwent thyroid surgery for the first time The Third Affiliated Hospital of Jinzhou Medical University from January 2020 to December 2023 and were pathologically confirmed as PTC were selected.According to the postoperative pathological results,the patients were divided into a metastasis group(90 cases)and a non-metastasis group(124 cases).The elastic strain rate ratio(SR)was obtained by strain elastography before operation,and the levels of serum Galectin-3,MMP-9 were detected.Multivariate Logistic regression equation was constructed to determine the influencing factors of cervical lymph node metastasis in PTC.The receiver operating characteristic curve(ROC)was drawn based on each independent risk factor to evaluate the predictive efficacy of each index alone or in combination for cervical lymph node metastasis in PTC.Results:The levels of SR and Galectin-3,MMP-9 in metastasis group were higher than those in non-metastasis group(P<0.05).Tumor diameter≥1 cm,microcalcification,high SR,high Galectin-3 and high MMP-9 were risk factors for cervical lymph node metastasis of PTC(P<0.05).The AUC of SR,Galectin-3 and MMP-9 predicted cervical lymph node metastasis of PTC was 0.827,0.814 and 0.824 respectively,and the AUC of combined prediction was 0.949,which was higher than that of single prediction.Conclusion:Strain elastography parameters SR and serum Galectin-3,MMP-9 levels were significantly increased in PTC patients with cervical lymph node metastasis,and the combination of SR and Galectin-3,MMP-9 has a high value in predicting the risk of cervical lymph node metastasis.

关 键 词：甲状腺乳头状癌 颈部淋巴结转移 应变弹性成像 半乳糖凝集素3 基质金属蛋白酶-9 

分 类 号：R736.1[医药卫生—肿瘤]