弹性成像参数与甲状腺微小癌病灶内细胞增殖和血管新生指标间的关系

Correlation between ultrasound elastography parameters and molecular prognostic parameters in patients with thyroid microcarcinoma

目的研究甲状腺微小癌(TMC)超声弹性成像应变率比值(SR)与病灶内癌细胞增殖及血管新生指标的相关性。方法选取2016年1月-2018年6月本院收治的231例甲状腺微小占位患者,共279个结节,其中良性结节130个,恶性结节149个。比较良恶性结节的SR值和细胞增殖及血管新生相关蛋白的表达水平,利用受试者工作特征曲线(ROC)评价SR值诊断TMC的价值。结果TMC组SR值显著高于良性结节组(P<0.01)。TMC组半乳糖凝集素3(Galectin-3)、碱性成纤维细胞生长因子(b-FGF)和血管内皮生长因子(VEGF)的表达水平均亦高于良性结节组,上述差异均有统计学意义(P<0.01)。Pearson相关性分析显示,SR与TMC中Galectin-3、b-FGF和VEGF的表达水平均呈正相关(P<0.05)。SR值诊断TMC的ROC曲线下面积为0.729,最佳截断值为3.85,敏感度为76.5%,特异度为67.3%。结论超声弹性成像SR值是诊断TMC的可靠指标,并与病灶内恶性生物学行为相关指标显著相关。

Objective To explore the correlation between strain ratio(SR)of ultrasound elastography and tumor cell growth and angiogenesis in thyroid microcarcinoma(TMC).Methods A total of 231 cases of thyroid small nodule in our hospital were collected during Jan.2016-Jun.2018.279 nodules were confirmed by postoperative pathology,including 130 benign nodules and 149 malignant nodules.The differences of SR and expression levels of tumor cell proliferation and angiogenesis related proteins between benign and malignant nodules were compared.The receiver operating characteristic curve(ROC)was used to evaluate the diagnostic value of SR value for TMC.Results The SR value of the TMC group was significantly higher than that of the benign nodule group(P<0.01).The expression levels of Galectin-3,basic fibroblast growth factor(b-FGF)and vascular endothelial growth factor(VEGF)in TMC group were higher than those in benign nodule group,with the differences statistically significant(P<0.01).Pearson analysis showed that SR was positively correlated with expressions of Galectin-3,b-FGF and VEGF(P<0.05).ROC curve showed that the area under SR value was 0.729 and the best cut-off value was 3.85.At this time,the sensitivity and specificity were respectively 76.5%and 67.3%.Conclusion The SR value of ultrasound elastography is a reliable index for the diagnosis of TMC,and is significantly related to the malignant biological behavior in the lesion.