实时剪切波弹性成像联合血清TG、VEGF水平对甲状腺乳头状癌患者颈部淋巴结转移的诊断价值  

Diagnostic Value of Shear Wave Elastography Combined with Serum TG and VEGF Levels for Cervical Lymph Node Metastasis in Patients with Papillary Thyroid Cancer

作　　者：王冬 彭艳艳 范新星 李雪 武林松[1] WANG Dong;PENG Yanyan;FAN Xinxing;LI Xue;WU Linsong(Department of Ultrasound Medicine,Fuyang People's Hospital,Fuyang,Anhui 236000,China;Department of Infection,Fuyang People's Hospital,Fuyang,Anhui 236000,China;Department of Clinical Laboratory,Fuyang People's Hospital,Fuyang,Anhui 236000,China)

机构地区：[1]阜阳市人民医院超声医学科,安徽阜阳236000 [2]阜阳市人民医院感染科,安徽阜阳236000 [3]阜阳市人民医院检验科,安徽阜阳236000

出　　处：《转化医学杂志》2024年第9期1385-1390,共6页Translational Medicine Journal

基　　金：阜阳市科技项目(F20220743)。

摘　　要：目的 探讨实时剪切波弹性成像(SWE)联合血清甲状腺球蛋白(TG)、血管内皮生长因子(VEGF)水平对甲状腺乳头状癌(PTC)患者颈部淋巴结转移(CLNM)的诊断价值。方法 选取2022年1月至2024年1月阜阳市人民医院收治的PTC并发CLNM患者60例为CLNM组,按照1∶1比例选择PTC未并发CLNM患者60例为非CLNM组,行SWE检查记录杨氏模量最大值(Emax)和最小值(Emin),并检测TG、VEGF水平。以PTC患者CLNM为因变量,多因素条件Logistic回归确定其影响因素,绘制受试者工作特征(ROC)曲线分析SWE联合血清TG、VEGF水平对其的诊断价值。结果 CLNM组Emax、Emin、TG、VEGF[109.71(82.26,148.95)kPa]、[41.63(33.12,50.28)kPa]、[21.36(11.69,36.95)ng/mL]、[59.81(40.05,98.25)ng/L]水平高于非CLNM组[54.42(33.19,82.55)kPa]、[32.66(20.04,36.88)kPa]、[12.23(7.04,16.49) ng/mL]、[35.61(21.42,50.05) ng/L](Z=-6.162、-5.131、-4.661、-6.002,P均<0.05)。PTC患者CLNM的独立危险因素为包膜侵犯(OR=12.182,95%CI:1.844~80.470)、Emax高(OR=1.057,95%CI:1.024~1.091)、Emin高(OR=1.125,95%CI:1.040~1.218)、TG高(OR=1.146,95%CI:1.050~1.250)、VEGF高(OR=1.108,95%CI:1.036~1.186)(P均<0.05)。SWE联合血清TG、VEGF水平诊断PTC患者CLNM的曲线下面积(AUC)为0.966(95%CI:0.916~0.991),大于SWE、TG、VEGF诊断的0.900(95%CI:0.832~0.947)、0.747(95%CI:0.659~0.822)、0.777(95%CI:0.692~0.848)(Z=2.723、5.002、4.020,P均<0.05)。结论 SWE参数Emax、Emin和血清TG、VEGF水平高与PTC患者CLNM有关,SWE联合血清TG、VEGF水平对PTC患者CLNM有较高的诊断价值。Objective To investigate the diagnostic value of shear wave elastography(SWE)combined with serum thyroglobulin(TG)and vascular endothelial growth factor(VEGF)levels in the diagnosis of cervical lymph node metastasis(CLNM)in patients with papillary thyroid carcinoma(PTC).Methods Sixty patients with PTC complicating CLNM admitted to our hospital from January 2022 to January 2024 were selected as the CLNM group,and 60 patients with PTC not complicating CLNM were selected as the non-CLNM group at a 1:1 ratio.SWE examination was performed to record the Young's modulus maximal(Emax)and minimal(Emin)value,and levels of TG and VEGF were measured.With CLNM in PTC patients as the dependent variable,multifactorial conditional Logistic regression was used to determine its influencing factors,and receiver operating characteristic curves were plotted to analyze the diagnostic value of SWE in combination with serum TG and VEGF levels.Results The levels of Emax,Emin,TG,and VEGF[109.71(82.26,148.95)kPa],[41.63(33.12,50.28)kPa],[21.36(11.69,36.95)ng/mL],and[59.81(40.05,98.25)ng/L]in the CLNM group were higher than those in the non CLNM group[54.42(33.19,82.55)kPa],[32.66(20.04,36.88)kPa],[12.23(7.04,16.49)ng/mL],and[35.61(21.42,50.05)ng/L](Z=-6.162,-5.131,-4.661,and-6.002,all P<0.05).The independent risk factors for CLNM in PTC patients were envelope invasion(OR=12.182,95%CI:1.844 to 80.470),high Emax(OR=1.057,95%CI:1.024 to 1.091),high Emin(OR=1.125,95%CI:1.040 to 1.218),high TG(OR=1.146,95%CI:1.050 to 1.250),and high VEGF(OR=1.108,95%CI:1.036 to 1.186)(all P<0.05).The area under the curve of SWE combined with serum TG and VEGF levels to diagnose CLNM in PTC patients was 0.966(95%CI:0.916 to 0.991),which was greater than that of SWE,TG,and VEGF diagnosis of 0.900(95%CI:0.832 to 0.947),0.747(95%CI:0.659 to 0.822),0.777(95%CI:0.692 to 0.848)(Z=2.723,5.002,4.020,all P<0.05).Conclusion High levels of SWE parameters(Emax and Emin)and serum TG and VEGF are associated with CLNM in patients with PTC,and SWE combined with serum TG and VEG

关 键 词：甲状腺乳头状癌 实时剪切波弹性成像 甲状腺球蛋白 血管内皮生长因子 颈部淋巴结转移 诊断 

分 类 号：R736.1[医药卫生—肿瘤]