MK、IGF-1以及Tg检测对甲状腺腺癌诊断及预后的价值分析

Diagnostic value of MK, IGF-1 and Tg in the diagnosis and prognosis of thyroid adenocarcinoma

目的探讨中期因子(MK)、胰岛素样生长因子-1(IGF-1)以及甲状腺球蛋白(Tg)检测对甲状腺腺癌诊断及预后的价值分析。方法回顾性选取2019年1月至2021年1月在庆阳市人民医院治疗的甲状腺腺癌患者78例作为观察组,选取同期甲状腺腺瘤患者70例作为甲状腺腺瘤组,另选取同期健康体检者50例作为对照组。检测3组血清MK、IGF-1和Tg水平,并分析其与甲状腺腺癌临床病理特征和预后的关系,以及不同指标联合检测对甲状腺腺癌诊断和预后的敏感度和特异度。结果观察组患者血清MK、IGF-1和Tg水平明显高于甲状腺腺瘤组和对照组,甲状腺腺瘤组血清MK、IGF-1和Tg水平显著高于对照组,差异均有统计学意义(P<0.05)。观察组患者血清MK、IGF-1和Tg水平与性别、年龄无关(P>0.05),肿瘤分期Ⅲ~Ⅳ期、肿瘤直径≥2 cm、乳头状甲状腺腺癌、有淋巴结转移、病灶数量多发患者血清MK、IGF-1和Tg水平明显高于Ⅰ~Ⅱ期、肿瘤直径<2 cm、其他甲状腺腺癌、无淋巴结转移、病灶数量单发,差异均有统计学意义(P<0.05)。血清MK、IGF-1和Tg联合检测诊断甲状腺腺癌曲线下面积分别为0.976,敏感度为94.9%,特异度为97.5%,其诊断价值明显高于单项检测(P<0.05)。甲状腺腺癌预后不良患者血清MK、IGF-1和Tg的水平明显高于预后良好患者,差异均有统计学意义(P<0.05)。血清MK、IGF-1和Tg联合检测诊断甲状腺腺癌曲线下面积分别为0.962,敏感度为88.9%,特异度为100.0%,其诊断价值明显高于单项检测(P<0.05)。结论甲状腺腺癌患者的血清MK、IGF-1和Tg水平较高,与患者的肿瘤分期、肿瘤直径、淋巴结转移情况等有一定关系。血清MK、IGF-1和Tg联合检测对甲状腺腺癌诊断及预后判断均有重要的临床价值,明显优于单个指标的诊断效能。

Objective To investigate the value of midkine(MK),insulin like growth factor-1(IGF-1),and thyroglobulin(Tg)in the diagnosis and prognosis of thyroid adenocarcinoma.Methods A total of 78 patients with thyroid adenocarcinoma treated in Qingyang People's Hospital from January 2019 to January 2021 were retrospectively selected as the observation group,70 patients with thyroid adenoma in the same period were selected as the thyroid adenoma group,and 50 healthy people were selected as the control group.The expression levels of MK,IGF-1 and Tg in serum of the three groups were detected,and their relationship with the clinicopathological characteristics and prognosis of thyroid adenocarcinoma was analyzed,as well as the sensitivity and specificity of combined detection of different indicators for the stage and prognosis of thyroid adenocarcinoma.Results The levels of MK,IGF-1 and Tg in the observation group were significantly higher than those in the control group and thyroid adenoma group,the levels of serum indexes in thyroid adenoma group were significantly higher than those in control group,the differences were statistically significant(P<0.05).The levels of MK,IGF-1 and Tg in the observation group were not related to gender and age(P>0.05),the expression levels of serum MK,IGF-1 and Tg in patients with tumor stageⅢ-Ⅳ,tumor diameter≥2 cm,papillary thyroid adenocarcinoma,lymph node metastasis,number of multiple lesions were significantly higher than those of stageⅠ-Ⅱ,tumor diameter<2 cm,other thyroid adenocarcinomas,no lymph node metastasis,ande number of single lesions,the differences were statistically significant(P<0.05).The area under the curve of combined detection of serum MK,IGF-1 and Tg in the diagnosis of thyroid adenocarcinoma was 0.976,the sensitivity was 94.9%,and the specificity was 97.5%.The diagnostic value of combined detection of serum MK,IGF-1 and TG was significantly higher than that of single detection(P<0.05).The levels of MK,IGF-1 and Tg in patients with poor prognosis were significantly higher than those in patients with good prognosis(P<0.05).The area under the curve of combined detection of serum MK,IGF-1 and TG in the diagnosis of thyroid adenocarcinoma was 0.962,the sensitivity was 88.9%,and the specificity was 100.0%.The diagnostic value of combined detection of serum MK,IGF-1 and Tg was significantly higher than that of single detection(P<0.05).Conclusion The levels of MK,IGF-1 and Tg were higher in patients with thyroid adenocarcinoma,which were related to tumor stage,tumor diameter and lymph node metastasis.The combined detection of serum MK,IGF-1 and Tg has important clinical value in the diagnosis and prognosis of thyroid adenocarcinoma,which is significantly better than the diagnostic efficiency of single index.