血清VEGF、vWF联合超声参数对甲状腺癌的诊断价值及与恶性程度的相关性

The Diagnostic Value of Serum VEGF,vWF Combined with Ultrasound Parameters in Thyroid Cancer and Its Correlation with the Degree of Malignancy

目的探讨血清血管内皮生长因子(VEGF)、血管性血友病因子(vWF)联合超声参数对甲状腺癌(TC)的诊断价值及与恶性程度的相关性。方法选取甲状腺结节患者108例,根据穿刺活检结果将其分为对照组(良性,n=70)和实验组(恶性,n=38)。比较两组血清VEGF、vWF及超声参数差异,分析血清VEGF、vWF水平与TC临床病理特征关系,观察血清VEGF、vWF联合超声参数对TC诊断效能,分析血清VEGF、vWF及超声参数与TC患者细胞增殖、凋亡相关分子的相关性。结果实验组血清VEGF、vWF水平均高于对照组(P<0.05);两组超声检查不同病灶边界、形态、内部结构、回声、甲状腺周围淋巴结肿大占比比较均有显著差异(P<0.05);年龄≥50岁TNM分期为Ⅲ或Ⅳ期、无淋巴结转移、肿瘤大小<10 cm患者血清VEGF、vWF水平更高(P<0.05);联合检测诊断TC准确度、敏感度、特异度、阳性预测值及阴性预测值均高于超声参数单独诊断TC,但两组间比较差异无统计学意义(P>0.05);实验组B淋巴细胞瘤-2蛋白(Bcl-2)、野生型p53诱导的磷酸酶1(Wipl)、血清钙结合蛋白A4(S100A4)、特异性核基质结合区结合蛋白1(SATB1)表达量均高于对照组(P<0.05);Pearson相关分析发现,血清VEGF、vWF及各超声参数与TC患者Bcl-2、Wipl、S100A4、SATB1表达量均呈正相关(P<0.05)。结论血清VEGF、vWF联合超声参数检测能有效提高TC诊断准确度、敏感度及特异度,且与TC恶性程度呈正相关。

Objective To investigate the diagnostic value of serum vascular endothelial growth factor(VEGF)and von Willebrand factor(vWF)combined with ultrasound parameters in the diagnosis of thyroid cancer(TC)and their correlation with the degree of malignancy.Methods A total of 108 patients with thyroid nodules were selected and divided into the control group(benign,n=70)and the experimental group(malignant,n=38)according to the results of needle biopsy.The differences in serum VEGF,vWF and ultrasound parameters were compared between the 2 groups.The relationship between serum VEGF and vWF levels and clinicopathological characteristics of TC was analyzed.To observe the diagnostic efficacy of serum VEGF,vWF combined with ultrasound parameters for TC.The correlations of serum VEGF,vWF and ultrasound parameters with cell proliferation and apoptosis-related molecules in TC patients were analyzed.Results The levels of serum VEGF and vWF in the experimental group were higher than those in the control group(P<0.05).There were significant differences in the boundary,shape,internal structure,echo,and percentage of lymphadenopathy around the thyroid between the 2 groups(P<0.05).Serum VEGF and vWF levels were higher in patients aged≥50 years,TNM stage III or IV,no lymph node metastasis,and tumor size<10 cm(P<0.05).The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of combined detection in diagnosing TC were all higher than those of ultrasound parameters alone in diagnosing TC.However,there was no significant difference in diagnostic efficiency between the 2 groups(P>0.05).The expression levels of B-lymphoma-2 protein(Bcl-2),wild-type p53-induced phosphatase 1(Wipl),S100 calcium binding protein A4(S100A4)and special AT rich sequence binding protein 1(SATB1)in the experimental group were higher than those in the control group(P<0.05).Pearson correlation analysis showed that serum VEGF,vWF and various ultrasound parameters were positively correlated with the expressions of Bcl-2,Wipl,S100A4 and SATB1 in TC patients(P<0.05).Conclusion The detection of serum VEGF and vWF combined with ultrasound parameters can effectively improve the diagnostic accuracy,sensitivity and specificity of TC,and is positively correlated with the malignancy of TC.