超声联合血清神经轴突导向分子5A、可溶性人白细胞抗原G检测在结节性甲状腺肿与甲状腺腺瘤鉴别诊断中的价值  

Value of ultrasound combined with serum Sema 5A and sHLA-G in differential diagnosis of nodular goiter and thyroid adenoma

作　　者：郭占芳 王煜 GUO Zhanfang;WANG Yu(Department of Ultrasound Medicine,the First Hospital of Zhangjiakou,Zhangjiakou 075000,China;Department of Nuclear Medicine,the First Hospital of Zhangjiakou,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院超声医学科,河北张家口075000 [2]张家口市第一医院核医学科,河北张家口075000

出　　处：《陕西医学杂志》2025年第3期354-357,363,共5页Shaanxi Medical Journal

基　　金：河北省重点研发计划项目(2021ZF0275);河北省张家口市重点研发计划项目(2121185D)。

摘　　要：目的:探讨超声联合血清神经轴突导向分子5A(Sema 5A)、可溶性人白细胞抗原G(sHLA-G)在结节性甲状腺肿与甲状腺腺瘤鉴别诊断中的价值。方法:选取甲状腺腺瘤患者110例(腺瘤组)和结节性甲状腺肿114例(结节组)为研究对象。超声检查甲状腺,进行血流信号分级,并检测收缩期峰值流速(Vmax)、舒张末期最低流速(Vmin)和阻力指数。酶联免疫吸附试验(ELISA)检测血清Sema 5A和sHLA-G水平。受试者工作特征(ROC)曲线分析超声联合血清Sema 5A、sHLA-G在结节性甲状腺肿与甲状腺腺瘤鉴别诊断中的价值。结果:两组甲状腺肿大和结节数目比较差异有统计学意义(P<0.05)。腺瘤组血流信号以Ⅱ级和Ⅲ级为主,结节组血流信号以0级为主,两组0级、Ⅱ级和Ⅲ级比较差异有统计学意义(均P<0.05)。与结节组比较,腺瘤组Vmin和阻力指数降低,血清Sema 5A和sHLA-G水平升高(均P<0.05)。超声指标(Vmin、阻力指数)联合血清Sema 5A、sHLA-G鉴别诊断结节性甲状腺肿与甲状腺腺瘤的曲线下面积(AUC)高于单项(均P<0.001)。结论:超声联合血清Sema 5A、sHLA-G对结节性甲状腺肿与甲状腺腺瘤有良好的鉴别诊断价值。Objective:To explore the value of ultrasound combined with serum semaphorin 5A(Sema 5A)and soluble human leukocyte antigen-G(sHLA-G)in the differential diagnosis of nodular goiter and thyroid adenoma.Methods:A total of 110 cases of thyroid adenoma(adenoma group)and 114 cases of nodular goiter(nodule group)were selected as the study objects.The thyroid was examined by ultrasound,blood flow signal was graded,and peak systolic flow rate(Vmax),end-diastolic minimum flow rate(Vmin),and resistance index were measured.Serum Sema5A and sHLA-G levels were detected by ELISA.ROC curve was used to analyze the value of ultrasound combined with serum Sema5A and sHLA-G in the differential diagnosis of nodular goiter and thyroid adenoma.Results:There were significant differences in the number of goiter and nodule between two groups(all P<0.05).The blood flow signal of adenoma group was mainly gradeⅡandⅢ,and that of nodule group was mainly grade 0,and the difference between two groups of grade 0,gradeⅡand gradeⅢwas statistically significant(all P<0.05).Compared with nodule group,Vmin and resistance index in adenoma group were decreased,and serum Sema 5A and sHLA-G levels were increased(all P<0.05).The AUC of ultrasonic parameters(Vmin,resistance index)combined with serum Sema5A and sHLA-G in the differential diagnosis of nodular goiter and thyroid adenoma was higher than that of single(all P<0.001).Conclusion:Ultrasound combined with serum Sema5A and sHLA-G has a good value in the differential diagnosis of nodular goiter and thyroid adenoma.

关 键 词：结节性甲状腺肿 甲状腺腺瘤 超声 神经轴突导向分子5A 可溶性人白细胞抗原G 鉴别诊断 

分 类 号：R581[医药卫生—内分泌]