血清TSH、Cyfra 21-1、TgAb联合15 MHz高频超声在HT背景下诊断PTC患者中的应用

Application of serum TSH,Cyfra 21-1,TgAb combined with 15 MHz high-frequency ultrasound in the diagnosis of PTC patients under the background of HT

目的 分析血清促甲状腺激素(TSH)、细胞白蛋白19片段(Cyfra21-1)、甲状腺球蛋白抗体(TgAb)联合15 MHz高频超声在桥本甲状腺炎(HT)背景下诊断甲状腺乳头状癌(PTC)患者中的应用价值。方法 收集2018年10月至2021年10月秦皇岛市工人医院收治的PTC合并HT患者104例(观察组),选取本院同期收治的甲状腺良性疾病者91例作为对照组。对比两组TSH、Cyfra 21-1、TgAb表达水平及高频超声征像差异,分析TSH、Cyfra 21-1、TgAb联合15 MHz高频超声对PTC合并HT的诊断价值。结果 观察组TSH、Cyfra 21-1、TgAb表达水平均高于对照组,差异均有统计学意义(P<0.05)。观察组患者高频超声征象中边缘毛躁、形态不规则、结节纵横比≥1、内部低回声、微钙化、血流分布为Ⅱ~Ⅲ级占比明显高于对照组,差异有统计学意义(P<0.05)。依据ROC曲线可知,TSH、Cyfra 21-1、TgAb联合高频超声检测对PTC合并HT诊断敏感度和特异度分别为78.40%、72.90%,AUC=0.804(95%CI:0.707~0.898),高于四者单独诊断(P<0.05)。结论 血清TSH、Cyfra 21-1、TgAb联合15 MHz高频超声对PTC合并HT诊断效能佳,对临床早期诊断具有一定参考价值。

Objective To analyze the application value of serum thyroid stimulating hormone(TSH),cellular albumin 19 fragment(Cyfra21-1),thyroglobulin antibodies(TgAb)combined with 15 MHz high-frequency ultrasonography in the diagnostic value of Papillary thyroid carcinoma(PTC)patients under Hashimoto thyroiditis(HT). Methods 104 patients with PTC combined with HT admitted to Qinhuangdao Workers’ Hospital from October 2018 to October 2021 were collected(observation group),and 91 patients with benign thyroid disease admitted to our hospital during the same period were selected as the control group.The expression levels of TSH,Cyfra 21-1 and TgAb and the differences of high-frequency ultrasound signs were compared between the two groups,and the diagnostic value of TSH,Cyfra 21-1 and TgAb combined with15 MHz high-frequency ultrasound for PTC complicated with HT was analyzed. Results The expression levels of TSH,Cyfra 21-1 and TgAb in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05). The proportion of high frequency ultrasound signs of borderlessness,irregular shape,nodular aspect ratio ≥1,internal low echo,microcalcification,and blood flow distribution grade Ⅱ-Ⅲin the observation group was significantly higher than that in the control group,the differences were statistically significant(P<0.05). According to the ROC curve,the sensitivity and specificity of TSH,Cyfra 21-1 and TgAb combined with high frequency ultrasound for the diagnosis of PTC complicated with HT were 78.40% and 72.90%,respectively,AUC=0.804(95% CI:0.707-0.898),which were higher than those of the four separate diagnoses(P<0.05). Conclusion Serum TSH,Cyfra 21-1 and TgAb combined with15 MHz high-frequency ultrasound has good diagnostic efficacy for PTC combined with HT,and has a certain reference value for early clinical diagnosis.