剪切波弹性成像弹性模量值对甲状腺癌颈淋巴结转移的诊断及与血管内皮生长因子C和血管内皮生长因子D的相关性  

The value of elastic modulus of shear wave elastography in the diagnosis of cervical lymph node metastasis of thyroid cancer and its correlation with vascular endothelial growth factor C and vascular endothelial growth factor D

作　　者：陈恺蓓 刘玲玉 杨婧 汤佳美 CHEN Kaibei;LIU Lingyu;YANG Jing;TANG Jiamei(Department of Ultrasound,Shanghai Changhai Hospital,Shanghai,201900,China;Department of Ultrasound,the First Affiliated Hospital of Naval Medical University,Shanghai,200433,China)

机构地区：[1]上海长海医院超声诊断科,上海201900 [2]海军军医大学第一附属医院超声科,上海200433

出　　处：《中国耳鼻咽喉头颈外科》2025年第2期109-115,共7页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的分析剪切波弹性成像(shear-wave elastograghy,SWE)弹性模量值对甲状腺癌颈淋巴结转移的诊断及与血管内皮生长因子C(VEGF-C)和VEGF-D的相关性。方法选取2022年1月~2024年1月经上海长海医院超声诊断科诊断为甲状腺癌患者120例,依据颈淋巴结是否转移分为转移组(n=37)和未转移组(n=83),对两组患者的临床资料和SWE弹性模量值进行比较,分层回归分析临床特征对SWE弹性模量值的影响。Logistic回归分析SWE弹性模量值与甲状腺癌颈淋巴结转移风险的独立关联性及各因素亚组分析。限制性立方条分析SWE弹性模量值与甲状腺癌颈淋巴结转移风险的剂量-反应关系。Logistic回归调整因素后分析SWE弹性模量值与VEGF-C、D水平的相关性。结果转移组男性比例、体重指数(BMI)、临床分期、病灶直径、促甲状腺素(TSH)、游离甲状腺素(FT4)、甲状腺球蛋白抗体(TgAb)阳性率、甲状腺过氧化物酶抗体(TPOAb)阳性率、VEGF-C、VEGF-D高于未转移组。不同临床特征下转移组的SWE参数弹性最大值(elastic maximum,Emax)、弹性平均值(elastic mean,Emean)、弹性比值(elastic ratio,Eratio)高于未转移组。分层回归分析中,患者性别、临床分期、病灶直径、生化指标(TSH、FT4、TgAb、TPOAb)对SWE参数产生显著正向影响。SWE参数与甲状腺癌颈淋巴结转移风险具有独立关联性,亚组分析显示,各亚组中SWE参数与甲状腺癌颈淋巴结转移风险的关联均有统计学意义(P<0.05)。限制性立方条分析表明,SWE参数与甲状腺癌风险的关联强度不存在非线性剂量-反应关系(P>0.05)。调整混杂因素后,Emax、Emean、Eratio与VEGF-C、VEGF-D均存在明显线性相关关系(P<0.05)。结论SWE弹性模量值对甲状腺癌颈淋巴结转移具有一定的诊断价值,SWE参数与VEGF-C和VEGF-D具有一定相关性。OBJECTIVE To analyze the value of elastic modulus of shear wave elastography in the diagnosis of cervical lymph node metastasis of thyroid cancer and its correlation with VEGF-C and VEGF-D.METHODS A total of 120 patients with thyroid cancer admitted to our hospital were divided into metastatic group(n=37)and non-metastatic group(n=83)according to whether the cervical lymph node metastasis.The clinical data and SWE elastic modulus values of the two groups were compared,and the effects of clinical characteristics on SWE elastic modulus values were analyzed by hierarchical regression.Logistic regression analysis was conducted to analyze the independent correlation between SWE elastic modulus and the risk of lymph node metastasis of thyroid cancer.The dose-response relationship between the elastic modulus of SWE and the risk of lymph node metastasis in thyroid cancer was analyzed with restricted cubic strips.The correlation between SWE elastic modulus and VEGF-C and D levels was analyzed after adjusting factors by Logistic regression.RESULTS The results of general data analysis showed that male proportion,BMI,clinical stage,lesion diameter,TSH,FT4,TgAb positive rate,TPOAb positive rate,VEGF-C and VEGF-D in metastatic group were higher than those in non-metastatic group.Under different clinical characteristics,SWE parameters Emax,Emean and Eratio in metastatic group were higher than those in non-metastatic group.In hierarchical regression analysis,gender,clinical stage,lesion diameter,biochemical indices(TSH,FT4,TgAb,TPOAb)had significant positive effects on SWE parameters.SWE parameters were independently associated with the risk of lymph node metastasis of thyroid cancer.Subgroup analysis showed that the association between SWE parameters and the risk of lymph node metastasis of thyroid cancer in all subgroups was statistically significant(P<0.05).There was no nonlinear dose-response relationship between SWE parameters and thyroid cancer risk(P>0.05).After adjusting for confounding factors,there was a significant li

关 键 词：甲状腺肿瘤 弹性成像技术 血管内皮生长因子C 血管内皮生长因子D 弹性模量值 颈淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]