甲状腺微小乳头状癌应用彩色多普勒超声联合剪切波弹性成像诊断价值探究

Diagnostic value of color Doppler ultrasonography combined with shear-wave elastography in thyroid micropapillary carcinoma

目的探讨彩色多普勒超声(CDUS)联合剪切波弹性成像(SWE)诊断甲状腺微小乳头状癌(PTMC)的价值。方法回顾性选取2020年10月至2022年12月在马鞍山十七冶医院诊治的51例PTMC患者(研究组)和同期治疗的49例甲状腺良性结节患者(对照组)为研究对象。比较两组临床资料、血清肿瘤标志物及CDUS、SWE定量参数,采用Pearson检验分析CDUS、SWE定量参数与血清肿瘤标志物的相关性,采用受试者工作特征(ROC)曲线评估CDUS、SWE定量参数诊断PTMC的价值。结果研究组血清癌胚抗原(CEA)、甲状腺球蛋白(TG)、半乳糖血凝素-3(Gal-3)水平、阻力指数(RI)、收缩期峰值流速(PSV)、弹性模量最小值(Emin)、弹性模量平均值(Emean)、弹性模量最大值(Emax)均高于对照组[(28.76±4.29)μg/L比(15.73±2.96)μg/L、(117.53±25.17)μg/L比(49.85±9.64)μg/L、(8.31±2.43)μg/L比(3.50±0.82)μg/L、0.85±0.21比0.54±0.13、(44.18±8.26)cm/s比(22.05±6.49)cm/s、(15.80±1.94)kPa比(12.97±1.58)kPa、(38.02±10.39)kPa比(23.16±7.83)kPa、(60.13±19.41)kPa比(34.65±11.87)kPa],差异有统计学意义(P<0.05)。Pearson检验结果显示,PTMC患者RI、PSV、Emin、Emean、Emax与血清CEA、TG、Gal-3水平呈正相关(P<0.05)。ROC曲线分析结果显示,RI、PSV、Emin、Emean、Emax联合诊断PTMC的曲线下面积为0.937。结论CDUS联合SWE可为临床诊断PTMC提供可靠参考依据。

Objective:To explore the value of color Doppler ultrasound(CDUS)combined with shear wave elastography(SWE)in the diagnosis of thyroid micropapillary carcinoma(PTMC).Methods:The clinical data were retrospectively collected including 51 patients with PTMC(study group)and 49 patients with benign thyroid nodules(control group)who treatment in Maanshan 17 Metallurgical Hospital from October 2020 to December 2022.The clinical data,serum tumor markers,CDUS quantitative parameters,and SWE quantitative parameters were compared between the two groups,the correlation between CDUS,SWE quantitative parameters and serum tumor markers were analyzed by Pearson test,and the diagnostic value of CDUS,SWE quantitative parameters were analyzed by receiver operating characteristic(ROC)curve.Results:The levels of serum carcinoembryonic antigen(CEA),thyroglobulin(TG),galactose hemagglutinin-3(Gal-3),resistance index(RI),peak systolic flow velocity(PSV),elasticity modulus minimum(E min),elasticity modulus mean(E mean),and elasticity modulus maximum(E max)in the study group were higher than those in the control group:(28.76±4.29)μg/L vs.(15.73±2.96)μg/L,(117.53±25.17)μg/L vs.(49.85±9.64)μg/L,(8.31±2.43)μg/L vs.(3.50±0.82)μg/L,0.85±0.21 vs.0.54±0.13,(44.18±8.26)cm/s vs.(22.05±6.49)cm/s,(15.80±1.94)kPa vs.(12.97±1.58)kPa,(38.02±10.39)kPa vs.(23.16±7.83)kPa,(60.13±19.41)kPa vs.(34.65±11.87)kPa,there were statistical differences(P<0.05).In patients with PTMC,the results of Pearson test showed that,RI,PSV,E min,E mean,and E max were positively correlated with serum CEA,TG,and Gal-3 levels(P<0.05).The results of ROC curve analysis showed that the area under the curve(AUC)of the combined diagnosis of PTMC by RI,PSV,E min,E mean,and E max was 0.937.Conclusions:CDUS combined with SWE can provide reliable reference for clinical diagnosis of PTMC.