摘要
目的分析血清微RNA-599(miR-599)联合血管内皮生长因子(VEGF)水平对分化型甲状腺癌(DTC)患者全腔镜甲状腺次全切除术后复发的预测效能。方法选取铜川市人民医院2017年1月至2022年3月收治的行全腔镜甲状腺次全切除术的DTC患者135例。患者术前均检测血清miR-599和VEGF水平,并收集患者术前临床相关资料。术后对患者进行为期2年的随访,根据术后复发情况将其分为复发组(31例)和无复发组(104例)。复发组男12例,女19例,年龄(51.26±7.32)岁;无复发组男48例,女56例,年龄(49.57±7.08)岁。计数资料采用χ^(2)检验或Fisher精确概率检验;计量资料采用独立样本t检验。患者术后复发的影响因素用多因素逐步logistic回归模型进行分析;血清miR-599联合VEGF水平预测患者术后复发的效能用受试者操作特征曲线(ROC)下面积(AUC)进行分析。结果复发组miR-599水平低于无复发组[(0.81±0.09)比(1.05±0.12)],VEGF水平高于无复发组[(32.55±5.26)ng/L比(24.83±4.07)ng/L](t=10.295、8.639,均P<0.001)。复发组Ⅲ~Ⅳ期占比[67.74%(21/31)比28.85%(30/104)]、抗甲状腺球蛋白抗体(TgAb)水平[(251.86±27.98)IU/ml比(211.43±23.49)IU/ml]高于无复发组,术中淋巴结清扫占比[22.58%(7/31)比44.23%(46/104)]、术后放射碘治疗占比[32.26%(10/31)比53.85%(56/104)]低于无复发组(t=8.040,χ^(2)=4.694、4.454,均P<0.05)。多因素逐步logistic回归分析显示,miR-599水平(OR=0.251,95%CI 0.109~0.576)是患者术后复发的独立保护因素,VEGF水平(OR=2.163,95%CI 1.256~3.722)、临床分期(OR=4.287,95%CI 1.908~9.631)、TgAb水平(OR=4.612,95%CI 2.172~9.789)是患者术后复发的独立危险因素(均P<0.05)。ROC显示,miR-599、VEGF及二者联合预测患者术后复发的灵敏度分别为71.00%、74.20%、90.30%,特异度分别为76.90%、72.10%、88.50%,AUC分别为0.824、0.794、0.931(均P<0.05)。结论血清VEGF水平是DTC患者全腔镜甲状腺次全切除术后复发的独立危险因素,血清mi
Objective To investigate the efficacy of serum microRNA-599(miR-599)and vascular endothelial growth factor(VEGF)levels in the prediction of recurrence of patients with differentiated thyroid cancer(DTC)after totally endoscopic subtotal thyroidectomy.Methods A total of 135 patients with DTC who underwent totally endoscopic subtotal thyroidectomy at Tongchuan People's Hospital from January 2017 to March 2022 were selected.The serum levels of miR-599 and VEGF in all the patients were detected before the operation.Their preoperative clinical data were collected.The patients were followed up for 2 years after the operation.According to the postoperative recurrence,they were divided into a recurrence group(31 cases)and a non-recurrence group(104 cases).There were 12 men and 19 women in the recurrence group;they were(51.26±7.32)years old.There were 48 men and 56 women in the non-recurrence group;they were(49.57±7.08)years old.The count data were analyzed byχ^(2) test or Fisher's exact probability test.The measurement data were analyzed by the independent-sample t test.The influencing factors of postoperative recurrence were analyzed by the multivariate stepwise logistic regression model.The predictive efficacies of serum miR-599 and VEGF levels in predicting postoperative recurrence were analyzed by the areas(AUC)under the receiver operating characteristic curves(ROC).Results The level of miR-599 in the recurrence group was lower than that in the non-recurrence group[(0.81±0.09)vs.(1.05±0.12)],and the level of VEGF in the recurrence group was higher than that in the non-recurrence group[(32.55±5.26)ng/L vs.(24.83±4.07)ng/L](t=10.295 and 8.639;both P<0.001).The proportion of the patients ofⅢ-Ⅳstage[67.74%(21/31)vs.28.85%(30/104)]and anti-thyroglobulin antibody(TgAb)level[(251.86±27.98)IU/ml vs.(211.43±23.49)IU/ml]in the recurrence group were higher than those in the non-recurrence groupm,and the proportions of the patients taking intraoperative lymph node dissection[22.58%(7/31)vs.44.23%(46/104)]and postoper
作者
杨凯
王斌锋
任彦顺
惠鹏
Yang Kai;Wang Binfeng;Ren Yanshun;Hui Peng(Department of Emergency Surgery,Tongchuan People's Hospital,Tongchuan 727000,China;Department of General Surgery,Tongchuan People's Hospital,Tongchuan 727000,China;Department of General Surgery,Ankang Central Hospital,Ankang 725000,China)
出处
《国际医药卫生导报》
2024年第13期2219-2224,共6页
International Medicine and Health Guidance News
基金
陕西省医学科研项目(2018C008)。
关键词
分化型甲状腺癌
微RNA-599
血管内皮生长因子
全腔镜甲状腺次全切除术
术后复发
预测效能
Differentiated thyroid cancer
MicroRNA-599
Vascular endothelial growth factor
Totally endoscopic subtotal thyroidectomy
Postoperative recurrence
Prediction efficacy
