摘要
目的分析超声血流定量参数结合鼠类肉瘤滤过性毒菌致癌同源体B(BRAF)基因突变检测对桥本甲状腺炎(HT)合并甲状腺癌的诊断价值。方法以2020年6月至2022年6月于南京医科大学附属逸夫医院就诊的HT合并甲状腺结节患者86例为研究对象,依据病理检查结果,将合并甲状腺癌的患者为恶性组(n=26),将合并甲状腺良性结节患者为良性组(n=60)。恶性组患者中依据淋巴结转移情况分为转移组(n=10)和未转移组(n=16)。所有研究对象均接受彩色多普勒超声检查及BRAF基因突变检测,对比良、恶性组患者搏动指数(PI)、阻力指数(RI)、血流频谱收缩期峰值速度(S)、舒张末期血流速度(D)、收缩期峰值速度与舒张末期血流速度比值(S/D)、BRAF基因突变情况;对比转移组与未转移组患者彩色多普勒血流显像(CDFI)血流检出率、2~3级血流信号检出率及BRAF基因突变情况,以受试者工作特征(ROC)曲线评价上述血流参数与BRAF基因突变对HT合并甲状腺癌的诊断价值,并评估上述指标及BRAF基因突变对甲状腺癌淋巴结转移的诊断价值。结果恶性组患者的PI、RI、S、D、S/D及BRAF基因突变阳性率高于良性组(P<0.05);转移组患者的CDFI血流检出率、2~3级血流信号检出率及BRAF基因突变阳性率高于未转移组(P<0.05)。ROC曲线分析结果显示,RI、PI、S、D、S/D及BRAF基因突变联合评估HT合并甲状腺癌的曲线下面积(AUC)为0.951,敏感度为88.46%,特异度为93.33%,联合评估效能优于各指标单独评估;同时CDFI血流检出率、2~3级血流信号检出率及BRAF基因突变联合评估甲状腺癌淋巴结转移的AUC为0.938,联合评估效能优于各指标单独评估。结论超声血流定量参数结合BRAF基因突变对HT合并甲状腺癌及淋巴结转移均具有一定的评估价值,且各指标联合评估效能更佳。
Objective To analyze the diagnostic value of ultrasound blood quantitative parameters combined with murine sarcoma filtering toxin oncogenic homolog B(BRAF)gene mutation in Hashimoto's thyroiditis(HT)with thyroid carcinoma.Methods A total of 86 patients with HT and thyroid nodules in Sir Run Run Hospital,Nanjing Medical University from June 2020 to June 2022 were selected as the research objects.The patients with thyroid cancer were included into the malignant group(n=26),and the patients with benign thyroid nodules were included into the benign group(n=60)according to the pathological examination results.The patients in the malignant group was divided into the metastasis group(n=10)and the non-metastasis group(n=16)according to whether lymph node metastasis occurred.All subjects underwent color Doppler ultrasonography and BRAF gene mutation detection.The pulsatility index(PI),resistance index(RI),peak systolic velocity(S),end diastolic velocity(D),peak systolic velocity to end diastolic velocity ratio(S/D)and BRAF gene mutation between the malignant group and the benign group were compared.The detection rate of blood flow signals by CDFI,the detection rate of blood flow signals of grade 2 to 3 and the mutation of BRAF gene between the metastasis group and the non-metastasis group were compared.The value of the above blood parameters and BRAF gene mutations in the diagnosis of HT complicated with thyroid cancer was evaluated by receiver operating characteristic(ROC)curve,and the value of the above blood parameters and BRAF gene mutation in the diagnosis of lymph node metastasis of thyroid cancer was evaluated.Results The PI,RI,S,D,S/D and positive rate of BRAF gene mutation in the malignant group were significantly higher than those in the benign group(P<0.05).The detection rate of blood flow signals by CDFI,the detection rate of blood flow signals of grade 2 to 3,and the positive rate of BRAF gene mutation in the metastasis group were significantly higher than those in the non-metastasis group(P<0.05).ROC curve
作者
张寅
唐立钧
陈晓丽
李振
徐樱
ZHANG Yin;TANG Li-jun;CHEN Xiao-li;LI Zhen;XU Ying(Department of Ultrasound,Sir Run Run Hospital,Nanjing Medical University,Nanjing Jiangsu 210000,China;Department of Nuclear Medicine,First Affiliated Hospital with Nanjing Medical University,Nanjing Jiangsu 210029,China;Nanjing Dian Medical Laboratory Co.,Ltd.,Nanjing Jiangsu 210000,China)
出处
《局解手术学杂志》
2024年第7期637-641,共5页
Journal of Regional Anatomy and Operative Surgery
基金
南京市卫生科技发展专项基金(YKJ21079)。
关键词
桥本甲状腺炎
甲状腺癌
诊断价值
超声血流定量参数
鼠类肉瘤滤过性毒菌致癌同源体B
淋巴结转移
Hashimoto's thyroiditis
thyroid carcinoma
diagnostic value
ultrasound blood quantitative parameters
murine sarcoma filtering toxin oncogenic homolog B
lymph node metastasis
