甲状腺乳头状癌超声特征及联合血清SIRT1对淋巴结转移的预测价值
Ultrasound characteristics of lymph node metastasis in papillary thyroid carcinoma and its predictive value in combination with serum SIRT1
黄小艳 1张影 1张翠萍 1李彦1
作者信息
- 1. 商丘市第一人民医院超声科,商丘 476000
- 折叠
摘要
目的 探讨分析甲状腺乳头状癌(papillary thyroid carcinoma,PTC)超声特征及其联合血清沉默信息调控子 1(silent mating-type information regulation2 homolog1,SIRT1)对淋巴结转移(lymph node metasta-sis,LNM)的预测价值.方法 选取2022年5月至2023年5月商丘市第一人民医院超声科检查的90例PTC患者,根据患者超声检查是否存在淋巴结肿大、低回声、边界不清晰、微钙化等情况,将患者分为LNM组(26例)和无LNM组(64例)取其血清样本,采用酶联免疫吸附试验双抗体夹心法检测血清SIRT1水平.采用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析超声特征和血清SIRT1对PTC患者LNM的预测价值.结果 与无LNM组比较,LNM组肿瘤多发病灶(P=0.001)、肿瘤直径≥1 cm(P=0.018)、低回声(P=0.005)、边界不清晰(P=0.001)、微钙化(P=0.0201)患者比例更高.LNM组血清SIRT1水平为(5.12±1.24)ng/mL,较无LNM组的(8.76±1.35)ng/mL更低(P＜0.001).ROC结果显示,血清SIRT1最佳截断值为7.59 ng/mL时,曲线下面积(area under the curve,AUC)为0.78(95％CI:0.746～0.835);此时敏感度和特异度分别为79.43％、71.56％.肿瘤数目多发、肿瘤直径≥1 cm、边界不清晰、微钙化、血清SIRT1＜7.59 ng/mL对评估PTC LNM具有较好临床价值,联合检测预测价值更高,此时敏感度高达84.57％.多因素分析,结果显示肿瘤边界不清晰(OR=2.812,95％CI:1.220～6.482)、微钙化(OR=4.145,95％CI:1.335～12.870)、血清SIRT1 降低(OR=2.399,95％CI:1.580～3.642)是影响PTC LNM的独立危险因素(P＜0.05).结论 PTC LNM超声呈现边界不清晰、微钙化特征,且其血清SIRT1降低,超声特征与血清SIRT1联合检测对预测LNM具有较好预测价值.
Abstract
Objective To investigate the ultrasonic characteristics of lymph node metastasis of papillary thyroid carcinoma and the predictive value of silent mating-type information regulation2 homolog1(SIRT1).Meth-ods 90 PTC patients admitted from May.2022 to May.2023 were selected.According to the ultrasonography of patients with lymph node enlargement,hypoecho,unclear boundary,microcalcification and other conditions,the pa-tients were divided into 26 cases in the LNM group and 64 cases without LNM.All patients underwent thyroid ultra-sonography,and their serum samples were collected.Serum SIRT1 levels were detected by enzyme-linked immuno-sorbent assay(ELISA)double-antibody sandwich method.ROC was used to analyze the predictive value of ultra-sonic characteristics and serum SIRT1 for LNM in PTC patients.Results Compared with the group without lymph node metastasis,the proportion of patients with multiple tumor lesions(P=0.001),tumor diameter ≥1 cm,hy-poecho,unclear boundary and microcalcification was higher in the group with lymph node metastasis(P＜0.05).The serum SIRT1 level of LNM group(5.12±1.24)ng/mL was lower than that of(8.76±1.35)ng/mL in the other group(P＜0.05).ROC results showed that when the optimal cut-off value of serum SIRT1 was 7.59 ng/mL,the area under the curve was 0.78(95％CI:0.746-0.835).The sensitivity and specificity were 79.43％and 71.56％,respec-tively.Multiple tumors,tumor diameter ≥1 cm(P=0.018),unclear boundaries(P=0.005),microcalcification(P=0.001),and serum SIRT1＜7.59 ng/mL(P＜0.001)had good clinical value in the evaluation of lymph node metasta-sis of papillary thyroid carcinoma,and the combined detection had a higher predictive value,with a sensitivity of 84.57％.Multivariate analysis showed that tumor boundaries were unclear(OR=2.812,95％CI:1.220-6.482),mi-crocalcification(OR=4.145,95％CI:1.335-12.870),and serum SIRT1 decreased(OR=2.399,95％CI:1.580-3.642)were independent risk factors for lymph node metastasis of papillary thyroid carcinoma(P＜0.05).Conclu-sions Lymph node metastasis of papillary thyroid carcinoma is characterized by unclear boundary and micro-cal-cification on ultrasound,and serum SIRT1 is decreased.The combined detection of ultrasound features and serum SIRT1 has a good predictive value in predicting lymph node metastasis in patients with papillary thyroid cancer.
关键词
甲状腺乳头状癌/淋巴结转移/超声特征/血清沉默信息调控子1Key words
Thyroid papillary carcinoma/Lymph node metastasis/Ultrasonic characteristics/Serum silence message regulator 1引用本文复制引用
基金项目
2020年度河南省医学科技攻关计划联合共建项目(LHGJ20200925)
出版年
2024
NETL
NSTL
万方数据