摘要
目的:探讨超声剪切波弹性成像(SWE)联合血浆循环游离DNA(cfDNA)对甲状腺结节良恶性的鉴别诊断价值。方法:选取病理证实的120例甲状腺结节患者作为研究对象,术前均完成超声SWE检查和血浆cfDNA的测定;以手术病理为金标准,通过受试者工作特征(ROC)曲线评价SWE参数、cfDNA及其联合鉴别诊断甲状腺结节良恶性的价值。结果:120例甲状腺结节病例中,良性结节41个,恶性结节79个。甲状腺恶性结节组患者弹性最大值(E_(max))、弹性平均值(E_(mean))高于良性结节组(P<0.05);血浆cfDNA浓度明显高于良性结节组(P<0.05)。ROC曲线分析显示,SWE、cfDNA及两者联合诊断的曲线下面积分别为0.751、0.585、0.774;联合诊断的敏感度高于单一SWE诊断(69.6%vs.62.0%),特异度高于单一cfDNA诊断(78.0%vs.58.5%)。结论:SWE联合血浆cfDNA检测可提高对甲状腺结节良恶性的鉴别诊断能力,值得临床推广。
Objective:To investigate the value of ultrasonic shear wave elastography(SWE)combined with plasma circulating free DNA(cfDNA)in the differential diagnosis of benign and malignant thyroid nodules.Methods:120 patients with thyroid nodules confirmed by surgery and pathology were selected as the research subjects.Ultrasound SWE examination and plasma cfDNA determination were performed before operation.With surgical pathology as the gold standard,the value of SWE parameters,cfDNA and their combination in the diagnosis of benign and malignant thyroid nodules was evaluated by receiver operating characteristic(ROC)curve.Results:Among 120 thyroid nodules,41 were benign and 79 were malignant.Compared with the benign nodules group,the maximum elasticity(E_(max))and average elasticity(E_(mean))in the malignant thyroid nodules group were significantly increased(P<0.05).The plasma cfDNA concentration in the malignant thyroid nodules group was significantly higher than that in the benign nodules group(P<0.05).ROC curve analysis showed that the area under the curve of SWE was 0.751,and the area under the curve of cfDNA was 0.585,the area under the curve of SWE combined with cfDNA was 0.774,the sensitivity was higher than that of single SWE(69.6%vs.62.0%),and the specificity was higher than that of single cfDNA(78.0%vs.58.5%).Conclusion:SWE combined with plasma cfDNA detection can improve the differential diagnosis ability of benign and malignant thyroid nodules,which is worthy of clinical promotion.
作者
李艳艳
任玉菊
黄红梅
陈艳青
LI Yan-yan;REN Yu-ju;HUANG Hong-mei;CHEN Yan-qing(Department of Ultrasound,the Second People s Hospital of Lianyungang,Lianyungang 222000,Jiangsu,China)
出处
《川北医学院学报》
CAS
2022年第11期1480-1483,共4页
Journal of North Sichuan Medical College
关键词
甲状腺结节
甲状腺癌
超声
剪切波弹性成像
循环肿瘤DNA
鉴别
诊断
Thyroid nodules
Thyroid cancer
Ultrasound
Shear wave elastography
Circulating tumor DNA
Identification
Diagnosis
