Predictive value of real-time shear wave elastography elasticity index combined with serum SIL-2R and MMP-2 levels in cervical lymph node metastasis of thyroid micropapillary carcinoma
Objective To investigate the predictive value of real-time shear wave elastography(SWE)elasticity in-dex combined with serum levels of soluble interleukin-2 receptor(sIL-2R)and matrix metalloproteinase-2(MMP-2)in cervical lymph node metastasis of thyroid micropapillary carcinoma(PTMC).Methods Ninety-eight patients with PTMC admitted to the Department of Ultrasound Medicine,Baoji Central Hospital from January 2020 to January 2023 were selected.All pa-tients underwent SWE examination before surgery to detect serum sIL-2R and MMP-2 levels.The patients were divided into a metastatic group(32 cases)and a non-metastatic group(66 cases),and 52 benign thyroid nodule patients were selected as the control group.Multivariate Logistic regression analysis of the factors of cervical lymph node metastasis in PTMC pa-tients.The value of receiver operating characteristic(ROC)curve analysis of SWE parameters and sIL-2R and MMP-2 in predicting cervical lymph node metastasis in PTMC patients.Results The age of metastatic subgroup was lower than that of non-metastatic subgroup,the proportion of multiple lesions,the proportion of envelope invasion,and the tumor diameter were higher than that of non-metastatic subgroup(t/x2/P=8.867/＜0.001,6.329/0.012,5.669/0.017,10.080/＜0.001).Emax,Emin and Emean in metastasis subgroups were higher than non-metastasis subgroups and control groups(F/P=100.582/＜0.001,289.716/＜0.001,183.654/＜0.001),but there was no significant difference between non-metastasis subgroups and control group(P＞0.05).Serum sIL-2R and MMP-2 levels in metastatic subgroup were higher than those in non-metastasis sub-group and control group(F/P=367.973/＜0.001,414.371/＜0.001).Capsular invasion,large tumor diameter,high Emax,high sIL-2R,and high MMP-2 were risk factors for cervical lymph node metastasis in PTMC patients[OR(95％CI)=3.459(1.534-7.802),2.321(1.144-4.709),1.902(1.088-3.325),1.702(1.066-2.719),1.748(1.078-2.838)].The area under the curve of Emax,sIL-2R,MMP-2 and the combined prediction of PTMC lymph node metastasis were 0.852,0.794,0.795 and 0.931,re-spectively,and the AUC of the combined prediction was greater than that of the single prediction(Z=1.953,2.940,2.674,P=0.023,＜0.001,0.005).Conclusion The Emax value of SWE parameters and the increase of serum sIL-2R and MMP-2 levels in patients with PTMC are associated with cervical lymph node metastasis,and the combination of Emax,sIL-2R and MMP-2 can predict the risk of cervical lymph node metastasis of PTMC.
维普
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