甲状腺微小癌患者超声影像学特征与血清TSH、VEGF水平的相关性分析

Correlation Analysis of Imaging Features and Serum TSH, VEGF Levels in Patients with Thyroid Micro Carcinoma

【目的】探讨甲状腺微小癌(TMC)患者超声影像学特征与血清促甲状腺激素(TSH)、血管内皮生长因子(VEGF)水平的相关性.【方法】选择2015年11月至2018年10月本院收治的60例TMC患者,所有患者经甲状腺乳头状癌基因检测BRAVFV600E突变为阳性,应用SIEMENS S2000超声成像仪扫描检查双侧甲状腺和颈部淋巴结情况,采用免疫组化法检测血清VEGF、TSH水平,比较不同血清VEGF、TSH水平患者双侧甲状腺和颈部淋巴结情况.【结果】本研究60例患者TSH水平均值为(4.23±1.58)mU/L,以4.23 mU/L为临界值将其分为高TSH组(≥4.23 mU/L)和低TSH组(<4.23 mU/L),结果显示,两组间肿物最大直径、纵横比(A/T)、边界清晰度、被膜侵犯情况及微钙化情况存在统计学差异(P<0.05).根据VEGF水平将其分为高VEGF组(≥27.34 U/mL)和低VEGF组(<27.34 U/mL),结果显示,两组间肿物最大直径、边界清晰度、被膜侵犯情况及微钙化情况存在统计学差异(P<0.05).TMC患者血清TSH、VEGF水平pearson相关性结果显示,血清TSH、VEGF水平相关系数为0.336,具有统计学意义(P<0.05).【结论】TMC超声甲状腺影像特征与血清TSH、VEGF水平的相关性主要在于对肿瘤的良恶性判断存在诸多的共性,因此两者联合检测可能会提高诊断的灵敏度和特异度.

【Objective】To investigate the correlation between the imaging characteristics of thyroid micro carcinoma(TMC)and the levels of serum TSH and VEGF.【Methods】From November 2015 to October 2018,60 patients with TMC in our hospital were selected.Bravfv600e mutation was detected to be positive in all patients by thyroid papillary carcinoma gene test.The bilateral thyroid and cervical lymph nodes were scanned by Siemens S2000 ultrasound imager.The levels of VEGF and TSH in serum were measured by immunohistochemistry,and the bilateral thyroid and cervical lymph nodes in patients with different levels of VEGF and TSH were compared.【Results】In this study,the mean TSH level of 60 patients was(4.23±1.58)mu/L,which was divided into high TSH group(≥4.23 mu/L)and low TSH group(<4.23 mu/L).The results showed that there were significant differences in the maximum diameter,aspect ratio(A/T),boundary definition,membrane invasion and microcalcification between the two groups(P<0.05).According to the level of VEGF,they were divided into high VEGF group(≥27.34 U/ml)and low VEGF group(<27.34 U/ml).The results showed that there were statistical differences in the maximum diameter of tumor,boundary clarity,membrane invasion and microcalcification between the two groups(P<0.05).The Pearson correlation of serum TSH and VEGF in TMC patients showed that the correlation coefficient of serum TSH and VEGF was 0.336,which was statistically significant(P<0.05).【Conclusion】The correlation between thyroid imaging characteristics of TMC and serum TSH,VEGF levels is mainly due to the common features of tumor benign and malignant judgment,so the combined detection of the two may improve the sensitivity and specificity of diagnosis.