超声联合血清VEGF、TSGF检查对分化型甲状腺癌的诊断价值及与临床病理特征的相关性

Diagnostic value of ultrasound combined with serum VEGF and TSGF in differentiated thyroid carcinoma and the correlation with clinicopathological features

目的:探讨超声联合血清血管内皮生成因子(VEGF)、肿瘤特异性生长因子(TSGF)检查对分化型甲状腺癌(DTC)的诊断价值及与DTC临床病理特征的相关性。方法:选取151例DTC患者为观察组,63例甲状腺结节患者为对照组;观察组患者再依据腺癌类型分为甲状腺乳头状癌组(PTC组,n=106)和甲状腺滤泡状癌组(FTC组,n=45)。比较各组患者彩色多普勒超声检查结果、血清VEGF及TSGF水平,分析超声联合血清VEGF、TSGF检查对DTC的诊断价值及与DTC临床病理特征的关系。结果:观察组与对照组患者超声检查不同病灶边界、形态、内部结构、回声、钙化、周围组织浸润及甲状腺周围淋巴结肿大患者的占比差异有统计学意义(P<0.05);观察组患者血清VEGF、TSGF水平高于对照组(P<0.05)。PTC组与FTC组患者超声检查不同病灶边界、形态、回声、钙化患者的占比差异有统计学意义(P<0.05);PTC组患者血清VEGF、TSGF水平低于FTC组(P<0.05)。相关性分析显示,血清VEGF、TSGF水平与肿瘤的侵袭、转移能力有关,且肿瘤越大、发生淋巴结转移患者者血清VEGF、TSGF水平越高(P<0.05)。超声联合血清VEGF、TSGF诊断DTC的准确率、灵敏度、特异度、阳性预测值和阴性预测值均高于单一超声诊断(P<0.05)。结论:DTC患者的超声表现、血清VEGF、TSGF水平存在异常,且血清VEGF、TSGF水平与DTC患者肿瘤的侵袭、转移能力有关;超声联合血清VEGF、TSGF检测可提高DTC诊断的准确性。

Objective:To explore the diagnostic value of ultrasound combined with serum vascular endothelial growth factor(VEGF)and tumor specific growth factor(TSGF)in differentiated thyroid carcinoma(DTC),and analyze the correlation between serum VEGF and TSGF levels and clinicopathological features of DTC.Methods:The clinical data of 151 patients with DTC(observation group)and 63 patients with thyroid nodules(control group)were retrospectively analyzed.The patients in the observation group were divided intopapillary thyroid carcinoma group(PTC group,n=106)and follicular thyroid carcinoma group(FTC group,n=45)according to the type of adenocarcinoma.The results of color Doppler ultrasonography and the levels of serum VEGF and TSGF were compared.The relationship of serum VEGF and TSGF levels in PTC group and FTC group with clinicopathological features of DTC,and the diagnostic value of ultrasound combined with serum VEGF and TSGF in DTC were analyzed.Results:The ultrasound examination results showed that there were statistically significant differences between the observation group and the control group in terms of lesion boundary,morphology,internal structure,echo,calcification,infiltration of surrounding tissue,and lymph node enlargement around the thyroid(P<0.05).Serum VEGF and TSGF levels of the observation group were significantly higher than those of the control group(P<0.05).There were statistically significant differences between PTC group and FTC group in terms of lesion boundary,morphology,echo,and calcification(P<0.05).Serum VEGF and TSGF levels of PTC group were significantly lower than those of FTC group(P<0.05).Serum VEGF and TSGF levels were related to invasion and metastasis of the tumor.The larger the tumor and the higher the risk of lymph node metastasis,the higher the serum VEGF and TSGF levels(P<0.05).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of ultrasound combined with serum VEGF and TSGF in the diagnosis of DTC were higher than those of ultrasound alone(P<0.05).Conclusion:Patients with DTC have abnormal ultrasound findings,serum VEGF and TSGF levels.Serum VEGF and TSGF levels are related to invasion and metastasis of the tumor.Ultrasound combined with serum VEGF and TSGF detection can improve the diagnostic accuracy of DTC.