超声定量技术联合血清微小RNA-599及半乳糖凝集素-3在甲状腺乳头状癌颈部淋巴结转移中的应用研究

Application of ultrasound quantitative technique combined with serum microRNA-599 and galectin-3 in cervical lymph node metastasis of papillary thyroid carcinoma

目的探讨超声甲状腺影像学报告与数据系统(TI-RADS)评分、血清微小RNA(miR)-599、半乳糖凝集素-3(Galectin-3)与甲状腺乳头状癌(PTC)颈部淋巴结转移的关系及联合评估效能。方法选取2019年3月至2021年3月华润医疗淮北矿工总医院收治的98例PTC患者,根据病理检查是否有颈部淋巴结转移分为转移组(48例)和无转移组(50例),比较两组基线资料、超声TI-RADS评分、血清miR-599、Galectin-3水平,采用多因素Logistic回归分析PTC患者颈部淋巴结转移的影响因素,采用受试者工作特征曲线(ROC曲线)及曲线下面积(AUC)分析超声TI-RADS评分联合血清miR-599、Galectin-3评估PTC患者颈部淋巴结转移的价值。结果转移组超声TI-RADS评分、血清Galectin-3水平高于无转移组[(11.72±2.85)分比(8.15±2.60)分、(5.54±1.76)μg/L比(4.02±1.27)μg/L],血清miR-599水平低于无转移组(0.25±0.08比0.36±0.10),差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,将临床分期控制后,超声TI-RADS评分、血清Galectin-3、miR-599是PTC患者颈部淋巴结转移的影响因素(P<0.05)。ROC曲线分析结果表明,超声TI-RADS评分联合血清Galectin-3、miR-599评估颈部淋巴结转移的AUC最大(为0.889);超声TI-RADS评分、血清Galectin-3高水平患者颈部淋巴结转移率高于低水平患者,miR-599高水平患者颈部淋巴结转移率低于低水平患者,差异均有统计学意义(P<0.05)。结论超声TI-RADS评分、血清Galectin-3、miR-599与PTC患者颈部淋巴结转移有关,联合检测有望成为评估颈部淋巴结转移的一个方案。

Objective To investigate the application of ultrasound thyroid imaging report and data system(TI-RADS)score,serum galectin-3,microRNA(miR)-599 in cervical lymph node metastasis of papillary thyroid carcinoma(PTC).Methods A total of 98 patients with PTC admitted to China Resources Medical Huaibei Miners General Hospital from March 2019 to March 2021 were selected and divided into the metastasis group(48 cases)and the non-metastasis group(50 cases)according to the state of cervical lymph node metastasis dignosedby the pathological examination.The baseline data,ultrasound TI-RADS score,serum galectin-3,miR-599 were compared between the two groups.Multivariate Logistic regression analysis was used to analyze the related factors of cervical lymph node metastasis,receiver operating characteristic(ROC)curve and the area under curve(AUC)were used to analyze the value ofpredicting cervical lymph node metastasis.Results The ultrasound TI-RADS scores and galectin-3 level in the metastasis group were higher than those in the non-metastasis group:(11.72±2.85)scores vs.(8.15±2.60)scores,(5.54±1.76)μg/L vs.(4.02±1.27)μg/L,the miR-599 level in the metastasis group was lower than that in the non-metastasis group:0.25±0.08 vs.0.36±0.10,there were statistical differences(P<0.05).The results of multivariate Logistic regression analysis showed that the ultrasound TI-RADS score,serum galectin-3 and miR-599 were still associated with cervical lymph node metastasis in PTC patients after controlling the clinical stage(P<0.05).The results of ROC curve analysis showed that the AUC for ultrasound TI-RADS score,serum galectin-3 combined with miR-599 in evaluating cervical lymph node metastasis was the largest(0.889).The metastasis rate of patients with high levels of ultrasound TI-RADS and serum galectin-3 were higher than those with low levels,and the metastasis rate of patients with high level of miR-599 was lower than that of patients with low level,there were statistical differences(P<0.05).Conclusions Ultrasound TI-RADS score,serumgalectin-3,miR-599 are related to cervical lymph node metastasis in PTC patients,and combined detection is expected to become a scheme for evaluating cervical lymph node metastasis.