摘要
目的 回顾性分析超声联合半乳凝素-3(Galectin-3)、细胞角蛋白19(CK19)、CD56在甲状腺乳头状癌(PTC)颈部淋巴结转移(CLNM)中的诊断价值.方法 回顾性选取2022年1月至2023年11月于安庆市立医院行手术治疗的98例PTC患者的临床资料.按照是否发生CLNM将98例PTC患者分为CLNM组(n=25)、非CLNM组(n=73).所有患者均行超声及Galectin-3、CK19、CD56诊断,观察两组性别、年龄及超声特征;PTC患者Galectin-3、CK19、CD56表达情况;两组Galectin-3、CK19、CD56表达情况;采用受试者操作特征(ROC)曲线分析超声联合Galectin-3、CK19、CD56对PTC CLNM的诊断价值;经多因素Logistic回归分析法分析导致PTC CLNM的因素.结果 两组性别、年龄、病灶部位、边缘规则情况、回声高低、回声均匀及病灶内部成分比较,差异均无统计学意义(P＞0.05);两组病灶数目、病灶最大径、被膜侵犯、纵横比及微钙化比较,差异均有统计学意义(P＜0.05).经免疫组织化学染色法检测,PTC患者 Galectin-3、CK19 及 CD56 的阳性表达率分别为 84.69％、82.65％、38.78％.CLNM 组患者 Galectin-3、CK19、CD56阳性表达率分别为100.00％、100.00％、12.00％,其中Galectin-3、CK19阳性表达率均高于非CLNM组(79.45％、76.71％),CD56阳性表达率低于非CLNM组(47.95％),差异均有统计学意义(P＜0.05).经ROC曲线分析,超声联合Galectin-3、CK19、CD56对PTC CLNM的诊断价值高于四者单独诊断PTC CLNM的诊断价值.经多因素Logistic回归分析,年龄＜30、病灶最大径＞10 mm、被膜侵犯、纵横比＞1、微钙化及Galectin-3、CK19是导致PTC CLNM的危险因素(P＜0.05),CD56 阳性是 PTC CLNM 的保护因素(P＜0.05).结论 超声联合 Galectin-3、CK19、CD56 对 PTC CLNM具有较高的诊断价值.
Abstract
Objective To retrospectively analyze the diagnostic value of ultrasound combined with Galectin-3(Galectin-3),cytokera-tin 19(CK19)and CD56 in cervical lymph node metastasis(CLNM)of papillary thyroid carcinoma(PTC).Methods The clinical data of 98 patients with PTC who underwent surgical treatment in Anqing Municipal Hospital from January 2022 to November 2023 were retrospectively select-ed,and they were divided into CLNM group(n=25)and non-CLNM group(n=73)according to whether CLNM occurred.All patients were diagnosed by ultrasound and Galectin-3,CK19,CD56.Gender,age and ultrasonic characteristics of the two groups were observed.The expres-sion of Galectin-3,CK19 and CD56 in PTC patients;the expression of Galectin-3,CK19 and CD56 in two groups were observed.The diagnos-tic value of ultrasound combined with Galectin-3,CK19 and CD56 in PTC CLNM was analyzed by receiver operating characteristic(ROC)curve.The factors affecting the occurrence of PTC CLNM were analyzed by multivariate Logistic regression analysis.Results There were no sta-tistically significant differences between the two groups in gender,age,lesion location,edge rule,echo height,echo uniformity and internal com-position of lesions(P＞0.05).There were statistically significant differences in number of lesions,maximum lesion diameter,capsular invasion,aspect ratio and microcalcification between the two groups(P＜0.05).The positive expression rates of Galectin-3,CK19 and CD56 in PTC pa-tients were 84.69％,82.65％and 38.78％,respectively.The positive expression rates of Galectin-3,CK19 and CD56 in CLNM group were 100.00％,100.00％and 12.00％,respectively,and the positive expression rates of Galectin-3 and CK19 in CLNM group were higher than those in non-CLNM group(79.45％and 76.71％),the positive expression rate of CD56 was lower than that of non-CLNM group(47.95％),the differences were statistically significant(P＜0.05).According to ROC curve analysis,the diagnostic value of ultrasound combined with Ga-lectin-3,CK19 and CD56 for PTC CLNM was higher than that of the four patients alone.Multivariate Logistic regression analysis showed that age＜30,maximum lesion diameter＞10 mm,capsule invasion,aspect ratio＞1,microcalcification,Galectin-3,CK19 were the risk factors for PTC CLNM(P＜0.05),and positive CD56 was the protective factor for PTC CLNM(P＜0.05).Conclusion Ultrasonography combined with Galectin-3,CK19 and CD56 has high diagnostic value in PTC CLNM.
基金项目
安徽省卫生健康委科研项目资助(AHWJ2021b119)
NETL
NSTL
万方数据