摘要
目的探讨血清E-钙粘连蛋白(E-cadherin)、血管内皮生长因子(VEGF)、细胞角蛋白19片段抗原21-1(CYFRA21-1)水平在甲状腺癌患者手术前后的变化及其对术后复发转移的预测价值。方法选取118例行甲状腺癌根治术的分化型甲状腺癌(DTC)患者为研究组,118例健康体检者为对照组;根据术后6个月复发转移情况,将DTC患者分为复发转移组33例与未复发转移组85例。比较对照组与研究组(术前)、研究组手术前后、复发转移组与未复发转移组血清E-cadherin、VEGF、CYFRA21-1水平,采用ROC曲线分析上述各指标对术后复发转移的预测价值。结果研究组血清E-cadherin水平显著低于对照组,血清VEGF、CYFRA21-1水平显著高于对照组(P<0.05);研究组术后2周血清E-cadherin水平显著高于术前,血清VEGF、CYFRA21-1水平显著低于术前(P<0.05);未复发转移组术后2周血清E-cadherin水平显著高于术后复发转移组,血清VEGF、CYFRA21-1水平显著低于术后复发转移组(P<0.05)。术后2周上述各指标联合检测预测DTC患者术后复发转移的AUC为0.862,敏感度为90.91%,特异度为75.29%。结论DTC患者术后血清中E-cadherin表达上调,VEGF、CYFRA21-1表达下调,各指标联合检测对复发转移具有较高的预测效能,可作为临床评估DTC患者术后复发转移情况的辅助指标。
Objective To investigate the changes of serumlevels of E-cadherin,vascular endothelial growth factor(VEGF)and cytokeratin 19 fragment antigen 21-1(CYFRA21-1)in patients with thyroid cancer before and after surgery and their predictive value for post-operative recurrent metastasis.Methods 118 patients with differentiated thyroid cancer(DTC)who underwent radical thyroidectomywere established as the study group,and 118 healthy subjectswho passed physical examination were selected as the control group;according to recurrent metastasis at 6 months after the operation,the DTC patients were divided into 33 cases of recurrent metastasis group and 85 cases of non-recurrent metastasis group.The serum levels of E-cadherin,VEGF,and CYFRA21-1 were compared between the control group and the study group(pre-operative),before and after surgery in the study group,and between the recurrent metastasis group and the non-recurrent metastasis group,and the predictive value of each of the above indexes for postoperative recurrent metastasis was analyzed by using ROC curves.Results The serum levels of E-cadherin were significantly lower and the serum levels of VEGF and CYFRA21-1 were significantly higher in the study group than in the control group(P<0.05);the serumlevelsof E-cadherin were significantly higher and the serum levels of VEGF and CYFRA21-1 were significantly lower than pre-operative levels in the study group at 2 weeks after surgery(P<0.05);the serum levels of E-cadherin were significantly higher in the non-recurrent metastasis group than in the postoperative recurrent metastasis group at 2 weeks postoperatively,and the serum levels of VEGF and CYFRA21-1 were significantly lower than those in the postoperative recurrent metastasis group(P<0.05).The AUC of the combined test of the above indicators at 2 weeks postoperatively for predicting postoperative recurrent metastasis in DTC patients was 0.862,with a sensitivity of 90.91%and a specificity of 75.29%.Conclusion After surgery,the expression of E-cadherin was up-regulated w
作者
孙晓光
李彬
洪帅
SUN Xiao-guang;LI Bin;HONG Shuai(rd waxd Department of General Surgery(Department of Thyroid and Breast Surgery),Yongcheng People’s Hospital,Yongcheng 476600,China)
出处
《实用临床医学（江西）》
CAS
2024年第1期34-37,49,共5页
Practical Clinical Medicine
