摘要
目的研究超声弹性成像(ultrasonic elastography,UE)和超声造影技术(contrast-enhanced ultrasound technique,CEUS)对分化型甲状腺癌(differentiated thyroid cancer,DTC)的诊断价值及各指标与DTC组织侵袭基因及增殖基因表达量的相关性。方法选择2019年1月至2022年1月在浙江省诸暨市人民医院超声科进行检查的DTC患者100例纳入甲状腺癌组,选择同期进行检查的100例甲状腺腺瘤患者纳入甲状腺腺瘤组。所有患者进行UE和CEUS检查,且对患者肿瘤组织中增殖基因和侵袭基因表达量进行检测。对达峰时间(time to peak,TTP)、造影剂平均通过时间(average time of contrast medium passage,MTT)和峰值强度(peak intensity,PI)进行记录,依据DTC患者的蓝色面积比值、病灶弹性比值、达峰时间、MTT和峰值强度的ROC最佳截断值将患者进行分组,即弹性值>1.66、蓝色面积比值>51.21%、峰值强度≤17.11dB、MTT≤36.39s、达峰时间≤18.90s为A组,反之为B组。应用SPSS 19.0进行数据分析,以P<0.05为差异具有统计学意义。结果甲状腺癌组的蓝色面积比值、病灶弹性比值高于甲状腺腺瘤组(蓝色面积比值:t=5.096,P<0.05;病灶弹性比值:t=7.665,P<0.05),甲状腺癌组的达峰时间、MTT和峰值强度低于甲状腺腺瘤组(达峰时间:t=22.691,P<0.05;MTT:t=12.253,P<0.05;峰值强度:t=10.407,P<0.05)。不同临床分期、包膜侵犯和淋巴结转移甲状腺癌组蓝色面积比值、病灶弹性比值、达峰时间、MTT和峰值强度之间差异均存在统计学意义(P<0.05)。绘制ROC曲线,应用蓝色面积比值、病灶弹性比值、达峰时间、MTT和峰值强度联合诊断DTC的AUC最大,联合检测的特异度为86.37%,其检测敏感度为80.16%。相对于甲状腺腺瘤组,甲状腺癌组组织的Xklp2靶蛋白(Xklp2 target protein,TPX2)、趋化因子受体4(chemokine receptor 4,CXCR4)、聚素金属蛋白酶9(polymetalloproteinase-9,ADAM9)基因表达量较高,但其TDCD4基因表达量较低(P<0.05
Objective To study the diagnostic value of ultrasonic elastography(UE)CEUS in differentiated thyroid cancer(DTC)and its correlation with invasive gene and proliferative gene expression in DTC tissue.Methods 100 DTC patients who were treated in the Ultrasound Department of Zhuji People’s Hospital of Zhejiang Province from Jan.2019 to Jan.2022 were retrospectively selected and included in the TC group,and 100 thyroid adenoma patients who were treated during the same period were included in the thyroid adenoma group.UE and CEUS tests were performed on all patients,and the expression levels of proliferative and invasive genes in tumor tissues were measured.Time to peak(TTP),average time of contrast medium passage(MTT)and peak intensity(PI)were recorded.DTC patients were divided into groups according to the blue area ratio,elastic ratio of lesions,optimal ROC truncation value of TTP,MTT and PI,that is,elastic value>1.66,blue area ratio>51.21%,PI≤17.11dB,MTT≤36.39s,TTP≤18.90s were group A,and vice president was Group B.SPSS 19.0 was used for data analysis,and P<0.05 was considered to be statistically significant.Results The blue area ratio and elastic ratio of lesions in TC group were higher than those in thyroid adenoma group(P<0.05),while TTP,MTT and PI in TC group were lower than those in thyroid adenoma group(P<0.05).There were statistically significant differences in blue area ratio,elastic ratio of lesions,TTP,MTT and PI among TC groups with different clinical stages,capsule invasion and lymph node metastasis(P<0.05).ROC curve was drawn.The AUC of DTC combined with blue area ratio,elastic ratio of lesions,TTP,MTT and PI was the highest,the specificity of combined detection was 86.37%,and the detection sensitivity was 80.16%.Compared with thyroid adenoma group,Xklp2 target protein(TPX2),chemokine receptor 4,CXCR4)and polymetalloproteinase-9(ADAM9)gene expression levels were higher,but TDCD4 gene expression levels were lower(P<0.05).The expression levels of TPX2,CXCR4 and ADAM9 genes in group A were higher
作者
蔡黎霞
孙泉
Cai Lixia;Sun Quan(Department of Ultrasound,Zhuji People’s Hospital,Zhuji 311800,China;Department of Ultrasound Medicine,Ganzhou People’s Hospital,Ganzhou 341000,China)
出处
《中华内分泌外科杂志》
CAS
2023年第1期46-51,共6页
Chinese Journal of Endocrine Surgery
基金
江西省卫健委科技计划项目(202120009)。
关键词
超声弹性成像
超声造影
分化型甲状腺癌
侵袭基因
增殖基因
甲状腺癌
Ultrasound elastography
Contrast-enhanced ultrasound
Differentiated thyroid cancer
Invasion genes
Proliferation genes
Thyroid carcinoma
