US-FNA联合血清CCL11、HMGB1对甲状腺乳头状癌淋巴结转移的诊断价值

Diagnostic Value of US-FNA Combined with Serum CCL11 and HMGB1 in Lymph Node Metastasis of Papillary Thyroid Carcinoma

目的探讨超声引导下细针穿刺细胞学检查(US-FNA)联合血清嗜酸性粒细胞趋化因子(CCL11)、高迁移率族蛋白B1(HMGB1)对甲状腺乳头状癌(PTC)淋巴结转移的诊断价值。方法选取PTC患者80例(80枚淋巴结具有可疑转移性淋巴结超声征象),分别对患者进行US-FNA检查,并检测患者血清CCL11、HMGB1水平,统计所有患者手术病理学检查结果;以手术病理学检查结果为“金标准”,观察US-FNA诊断PTC淋巴结转移检出情况;比较PTC淋巴结转移与未转移患者血清CCL11、HMGB1水平;受试者工作特征曲线(ROC)分析US-FNA联合血清CCL11、HMGB1对PTC患者淋巴结转移的诊断价值。结果80枚淋巴结经手术病理学检查淋巴结转移检出率为88.75%(71/80);以手术病理学检查结果为“金标准”,US-FNA检出59例,漏诊12例,淋巴结转移诊断敏感度为83.10%(59/71)、特异度为100%(9/9);PTC淋巴结转移患者的血清CCL11、HMGB1水平均高于未转移患者(P<0.05);ROC结果显示,CCL11、HMGB1对PCI淋巴结转移诊断的最佳截断点分别为63.04 pg/ml、16.36 ng/ml,曲线下面积(AUC)分别为0.851、0.814,US-FNA联合血清CCL11、HMGB1对PTC淋巴结转移诊断的AUC为0.901。结论US-FNA联合血清CCL11、HMGB1诊断PTC淋巴结转移的准确度、敏感度、特异度较高,具有较高临床应用价值。

Objective To investigate the diagnostic value of ultrasound-guided fine needle aspiration cytology(US-FNA)combined with serum C-C motif chemokine 11(CCL11)and high-mobility group box 1(HMGB1)for lymph node metastasis in papillary thyroid carcinoma(PTC).Methods A total of 80 patients with PTC were selected(80 lymph nodes with ultrasound signs of suspicious metastatic lymph nodes).The patients were examined by US-FNA,and the serum levels of CCL11 and HMGB1 were detected.The surgical pathological examination results of all patients were counted.Using the results of surgical and pathological examination as the"gold standard",the detection of lymph node metastasis in PTC was observed by US-FNA.The levels of CCL11 and HMGB1 in serum of patients with PTC lymph node metastasis and those without metastasis were compared.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of US-FNA combined with serum CCL11 and HMGB1 for lymph node metastasis in patients with PTC.Results The detection rate of lymph node metastasis in 80 lymph nodes was 88.75%(71/80)by surgical and pathological examination.Taking surgical and pathological examination results as the"gold standard",US-FNA detected 59 cases and missed 12 cases,the diagnostic sensitivity of lymph node metastasis was 83.10%(59/71)and a specificity of 100%(9/9)for the diagnosis of lymph node metastasis.The serum levels of CCL11 and HMGB1 in patients with PTC lymph node metastasis were higher than those in patients without metastasis(P<0.05).The ROC results showed that the optimal cut-off points of CCL11 and HMGB1 for the diagnosis of PCI lymph node metastasis were 63.04 pg/ml and 16.36 ng/ml,respectively,and the area under the curve(AUC)s were 0.851 and 0.814,respectively.The AUC for diagnosis was 0.901.Conclusion US-FNA combined with serum CCL11 and HMGB1 has high accuracy,sensitivity and specificity in the diagnosis of PTC lymph node metastasis,and has high clinical application value.