摘要
目的研究血清甲状腺球蛋白(PS-Tg)、E-cadherin结合超声影像特征对甲状腺乳头状癌(PTC)颈部淋巴结转移的诊断价值。方法选取2020年5—2022年5月本院收治的190例PTC患者,术后均进行病理检查,并分为转移组(颈部淋巴结转移)102例和未转移组(颈部淋巴结未转移)88例,比较两组一般资料及超声影像特征。结果转移组Ⅲ期比例、ps-Tg、E-cadherin及T-钙黏蛋白高于未转移组(P<0.05);转移组肿瘤最大径0.7~1 cm、淋巴结内囊性变、多发病灶、甲状腺包膜累及程度高于50%、收缩期峰值血流速度(PSV)>13.95 cm/s、RI>0.74比例高于未转移组(P<0.05);Logistic回归分析结果显示,cTNM分期、ps-Tg、E-cadherin、T-钙黏蛋白、淋巴结内囊性变、肿瘤最大径、甲状腺包膜累及程度、病灶数目、PSV是PTC患者部淋巴结转移的独立危险因素(P<0.05);ROC分析结果显示,经ps-Tg、E-cadherin、T-钙黏蛋白、肿瘤最大径、甲状腺包膜累及程度及PSV单独诊断PTC患者发生颈部淋巴结转移的AUC值分别为0.846、0.572、0.846、0.853、0.870和0.826,联合诊断的AUC值为0.941,显著高于各指标分别诊断。结论PS-Tg、E-cadherin结合超声影像特征对甲状腺乳头状癌颈部淋巴结转移诊断价值较高。
Objective To research on the diagnostic value of preoperative serum thyroglobulin(PS-Tg)and E-cadherin combined with ultrasound imaging characteristics for cervical lymph node metastasis in papillary thyroid carcinoma(PTC).Methods A total of 190 patients with papillary thyroid carcinoma(PTC)admitted to our hospital from May 2020 to May 2022 were selected.After surgery,pathological examinations were carried out on all of them,and they were divided into two groups:the metastatic group(with cervical lymph node metastasis,102 cases)and the non-metastatic group(without cervical lymph node metastasis,88 cases).The general data and ultrasonic imaging characteristics of the two groups were compared.Results The proportion of stageⅢ,ps-Tg,E-cadherin,and T-cadherin in the metastatic group were higher than those in the non-metastatic group(P<0.05).The proportions of tumor maximum diameter ranging from 0.7 cm to 1 cm,cystic change in lymph nodes,multiple lesions,thyroid capsule involvement exceeding 50%,peak systolic velocity(PSV)>13.95 cm/s,and RI>0.74 in the metastatic group were higher than those in the non-metastatic group(P<0.05).Logistic regression analysis was performed as follows:cTNM stage,ps-Tg,E-cadherin,T-cadherin,cystic change in lymph nodes,tumor maximum diameter,degree of thyroid capsule involvement,number of lesions,and PSV were independent risk factors for cervical lymph node metastasis in PTC patients(P<0.05).The results of ROC analysis showed that the AUC values for the individual diagnosis of cervical lymph node metastasis in PTC patients by ps-Tg,E-cadherin,T-cadherin,tumor maximum diameter,degree of thyroid capsule involvement,and PSV were 0.846,0.572,0.846,0.853,0.870,and 0.826 respectively.The AUC value of the combined diagnosis was 0.941,which was significantly higher than that of each individual indicator for diagnosis.Conclusion PS-Tg,E-cadherin,when combined with ultrasonic imaging features,possess relatively high diagnostic value for cervical lymph node metastasis in papillary thyroid carcinoma.
作者
宁晓云
申雅雯
常淑娟
台明辉
樊扬威
NING Xiaoyun;SHEN Yawen;CHANG Shujuan;TAI Minghui;FAN Yangwei(Department of Medical Oncology,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Ultrasound Imaging,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《西部医学》
2025年第9期1300-1304,共5页
Medical Journal of West China
基金
陕西省2022年科技计划项目(2022JQ-758)。
关键词
甲状腺球蛋白
超声影像特征
甲状腺乳头状癌
颈部淋巴结转移
淋巴结内囊性变
收缩期峰值血流速度
Thyroglobulin
Ultrasound imaging characteristics
Papillary thyroid carcinoma
Cervical lymph node metastasis
Cystic changes within lymph nodes
Peak systolic velocity
