探讨LMTK3检测对甲状腺乳头状癌的诊断及颈部淋巴结转移和分期的意义

Investigatation on the Significance of LMTK3 Detection in the Diagnosis of Papillary Thyroid Carcinoma and Cervical Lymph Node Metasta-sis and Staging

目的探讨Lemur-酪氨酸激酶3(LMTK3)检测对甲状腺乳头状癌(PTC)的诊断及颈部淋巴结转移和分期的意义。方法选取徐州医科大学附属医院甲状腺乳头状癌外科住院行手术治疗的患者128例,术前抽血检测LMTK3及甲状腺功能七项,根据术后病理分为甲状腺乳头状癌组(PTC,n=71)和结节性甲状腺肿组(NG,n=57),以Logistic回归建立预测模型,对观察指标做回归分析并绘制ROC曲线,评价不同观察对象对诊断PTC的意义,并分析LMTK3与PTC侵袭及淋巴结转移等的关系。结果临床资料比较中,与NG组比较,PTC组LMTK3、TSH、TG水平升高(P<0.05)。单因素Logistic分析中,LMTK3、TSH、TG与PTC之间均存在明显的相关性(P<0.05);多因素Logistic分析中,LMTK3、TSH在模型中比较差异有统计学意义,为PTC发生的独立危险因素(P<0.05)。ROC曲线显示,LMTK3、TSH以及二者联合诊断PTC的AUC分别为0.809、0.720和0.849(P<0.05)。进一步结果表明,LMTK3水平与PTC侵袭性分期及淋巴结转移密切相关(P<0.05)。结论PTC患者血清LMTK3及TSH水平升高,两者联合可用于指导临床诊断PTC,血清LMTK3水平与PTC淋巴结转移及疾病分期有关。

Objective To investigate the significance of lemur tyrosine kinase-3(LMTK3)detection in the diagnosis of papillary thyroid carcinoma(PTC)and cervical lymph node metastasis and staging.Methods A total of 128 patients treated by breast surgery in the Affiliated Hospital of Xuzhou Medical University were selected.LMTK3 and thyroid function were detected by preoperative blood sample.According to pathology,they were divided into papillary thyroid carcinoma group(PTC,n=71)and nodular goiter group(NG,n=57).Logistic regression model was established and ROC curve was drawn to evaluate the significance of different observed objects in the diagnosis of PTC.The relationship between LMTK3 and PTC invasion and lymph node metastasis was analyzed.Results In the comparison of clinical data,the levels of LMTK3,TSH and TG increased in the PTC group(P<0.05).In univariate logistic analysis,there were significant correlations between LMTK3,TSH,TG and PTC(P<0.05);in multivariate logistic analysis,LMTK3 and TSH were statistically significant in the model and were independent risk factors for PTC(P<0.05).The ROC curve showed that the AUC of LMTK3,TSH and their combination were 0.809,0.720 and 0.849,and the corresponding P values were all less than 0.05.Further results showed that LMTK3 levels were closely correlated with invasive stage and lymph node metastasis of PTC.Conclusion Serum LMTK3 and TSH levels were elevated in PTC patients,the combination of the two can be used for clinical diagnosis of PTC,serum LMTK3 level was associated with PTC lymph node metastasis and disease stage.