摘要
目的:探究超声造影(CEUS)定量参数及血清中期因子(MK)在甲状腺微小癌(TMC)患者体内的变化情况及其与射频消融(RFA)治疗效果的关系。方法:选取2016年1月~2018年1月我院96例TMC患者作为恶性组,随机选取同期83例甲状腺良性结节患者作为良性组。比较两组CEUS定量参数[造影剂平均通过时间(MTT)、峰值强度(Peak)]、血清MK水平,分析CEUS定量参数、血清MK与TMC患者临床特征的相关性,比较恶性组RFA治疗后不同疗效患者治疗前后CEUS定量参数、血清MK水平,探究各指标预测RFA治疗效果价值及与疗效的关系。结果:恶性组MTT、血清MK水平高于良性组,Peak低于良性组(P<0.05);Peak、MTT、血清MK水平与肿瘤直径、甲状腺超声影像和数据报告系统(TI-RADS)分级、包膜侵犯、淋巴结转移有关;Peak、MTT、血清MK差值中,Peak差值预测RFA治疗效果的AUC最大,为0.787,截断值下预测的敏感度为76.47%、特异度为69.62%;随着Peak降低、MTT及血清MK水平升高,TMC患者RFA治疗效果越差(P<0.05)。结论:CEUS定量参数、血清MK在TMC患者中呈异常表达,并与临床病理特征存在一定相关性,可为预测RFA治疗效果提供循证指导。
Objective:To explore the changes of quantitative parameters of contrast-enhanced ultrasound(CEUS)and serum midkine(MK)in patients with thyroid micro carcinoma(TMC)and their relationship with radiofrequency ablation(RFA).Methods:From January 2016 to January 2018,96 patients with TMC in our hospital were selected as the malignant group,and 83 patients with benign thyroid nodules in the same period were randomly selected as the benign group.Comparing the CEUS quantitative parameters[mean transit time(MTT),peak intensity(Peak)],serum MK level of the two groups,analyzing the correlation between CEUS quantitative parameters,serum MK and clinical characteristics of TMC patients.Comparing the quantitative parameters of CEUS and serum MK levels before and after treatment in patients with different curative effects after RFA treatment in the malignant group,and exploring the value of each index to predict the effect of RFA treatment and the relationship with the curative effect.Results:The MTT and serum MK levels of the malignant group were higher than those of the benign group,and Peak was lower than the benign group(P<0.05);Peak,MTT,and serum MK levels were related to tumor diameter,thyroid ultrasound imaging and data reporting system(TI-RADS)classification,capsule invasion,and lymph node metastasis;among the peak,MTT,and serum MK differences,the peak difference predicted the highest AUC of the RFA treatment effect,which was 0.787.The predicted sensitivity under the cut-off value was 76.47%and the specificity was 69.62%;with the decrease of Peak and the increase of MTT and serum MK levels,the treatment effect of RFA in TMC patients became worse(P<0.05).Conclusion:CEUS quantitative parameters and serum MK are abnormally expressed in TMC patients,and have a certain correlation with clinicopathological characteristics,which can provide evidence-based guidance for predicting the effect of RFA treatment.
作者
贺丽
张彤
欧阳飞
利孝鹏
He Li;Zhang Tong;Ouyang Fei;Li Xiaopeng(Ultrasound Medical Center,First People's Hospital of Chenzhou City,Chenzhou,Hunan 423000)
出处
《现代科学仪器》
2020年第5期68-73,共6页
Modern Scientific Instruments
关键词
甲状腺微小癌
超声造影
中期因子
射频消融
临床特征
Thyroid micro carcinoma
Contrast-enhanced ultrasound
Midkine
Radiofrequency ablation
Clinical features
