^(131)I SPECT/CT断层显像联合血清GPX3水平检测对分化型甲状腺癌患者淋巴结转移的诊断价值分析  

The Diagnostic Value of ^(131)I SPECT/CT Combined with the Serum GPX3 Level Detection in Lymph Node Metastasis in Patients with Differentiated Thyroid Cancer

作　　者：卢颖俏 王永宁 卢瑞瑞 刘姗姗 LU Yingqiao;WANG Yongning;LU Ruirui;LIU Shanshan(Department of Nuclear Medicine,Kaifeng Central Hospital)

机构地区：[1]开封市中心医院核医学科,河南开封475000

出　　处：《长治医学院学报》2025年第1期57-60,共4页Journal of Changzhi Medical College

摘　　要：目的:探讨^(131)I单光子发射CT/CT(SPECT/CT)断层显像联合血清谷胱甘肽过氧化物酶3(GPX3)水平检测对分化型甲状腺癌患者淋巴结转移的诊断价值。方法:回顾性分析85例分化型甲状腺癌患者,根据手术及病理检查结果分为淋巴结转移组(n=36)、未转移组(n=49),入院后均行^(131)I SPECT/CT断层显像检查,比较2组临床资料及血清GPX3水平,并比较^(131)I SPECT/CT断层显像、血清GPX3对分化型甲状腺癌患者淋巴结转移单独、联合诊断价值。结果:与未转移组比较,转移组病灶数目多发、肿瘤直径≥2 cm、临床分期Ⅲ~Ⅳ期、被膜侵犯、低分化比例较高,血清GPX3水平较低(P<0.05);^(131)I SPECT/CT断层显像、血清GPX3联合诊断灵敏度为91.67%、准确度为94.12%,高于单独^(131)I SPECT/CT断层显像检查(灵敏度为66.67%、准确度为84.71%)及血清GPX3检查(灵敏度为61.11%、准确度为81.18%)。结论:SPECT/CT断层显像联合血清GPX3可提高对分化型甲状腺癌患者淋巴结转移的诊断准确率、降低漏诊率。Objective:To evaluate the diagnostic value of ^(131)I SPECT/CT combined with the serum glutathione peroxidase 3(GPX3)level detection in lymph node metastasis in patients with differentiated thyroid carcinoma.Methods:A total of 85 patients with differentiated thyroid cancer treated were retrospectively selected and divided into the lymph node metastasis group(n=36)and the non-metastatic group(n=49)according to surgical and pathological findings.^(131)I SPECT/CT was performed after admission.The clinical data and serum GPX3 levels of the two groups were compared,and the single and combined diagnosis results and diagnostic efficacy of ^(131)I SPECT/CT and serum GPX3 for lymph node metastasis in patients with differentiated thyroid cancer were compared.Results:Compared with the non-metastatic group,the metastatic group had a higher number of lesions,tumor diameter≥2 cm,clinical stage Ⅲ~Ⅳ,membrane invasion,low differentiation ratio,and lower serum GPX3 level(P<0.05).The results of ^(131)I SPECT/CT showed that 25 of the 85 patients with differentiated thyroid cancer had lymph node metastasis,the results of serum GPX3 showed lymph node metastasis in 24 cases,and the combined diagnosis showed lymph node metastasis in 35 cases.The sensitivity and accuracy of ^(131)I SPECT/CT combined with serum GPX3 were 91.67%and 94.12% respectively.Higher than ^(131)I SPECT/CT(sensitivity 66.67%,accuracy 84.71%)and serum GPX3(sensitivity 61.11%,accuracy 81.18%).missed diagnosis was 8.33%,it was 33.33% lower than ^(131)I SPECT/CT and 38.89% lower than serum GPX3.Conclusion:SPECT/CT combined with serum GPX3 has a high diagnostic value for lymph node metastasis in patients with differentiated thyroid cancer,and provides a reference for early diagnosis of lymph node metastasis in clinical practice,to formulate corresponding intervention plans.

关 键 词：^(131)I SPECT/CT断层显像 谷胱甘肽过氧化物酶3 分化型甲状腺癌 淋巴结转移 

分 类 号：R446[医药卫生—诊断学]