超声造影联合血清SMURF1检测诊断甲状腺癌的临床分析OACSTPCD
Clinical analysis of contrast-enhanced ultrasound combined with serum SMURF1 detection in the diagnosis of thyroid cancer
目的 探讨超声造影联合血清Smad泛素调节因子1(SMURF1)检测对甲状腺癌的诊断价值.方法 纳入东南大学附属中大医院溧水分院2019年2月至2020年2月收治的144例疑似甲状腺癌患者为研究对象,根据组织病理学结果,将其分为甲状腺癌组(76例)和良性组(68例).所有患者均行超声造影检查及血清SMURF1水平测定;分析超声造影参数、血清SMURF1单独检测及二者联合检测对甲状腺癌的诊断价值.结果 甲状腺癌组超声造影参数峰值强度(PI)、平均灌注强度(SImean)及最大灌注强度(SImax)均低于良性组,SMURF1 mRNA水平高于良性组(P<0.05).超声造影参数SImax诊断甲状腺癌的敏感度为82.89%,特异度为72.06%,准确度为77.78%,Kappa值为0.552.血清SMURF1诊断甲状腺癌的敏感度为65.79%,特异度为94.12%,准确度为79.17%,Kappa值为0.589.SImax联合SMURF1诊断的敏感度、特异度、准确度、Kappa值分别为97.37%、85.29%、91.67%、0.832,均高于SImax、SMURF1单独诊断(P<0.05),且二者联合预测预后的AUC为0.927,明显高于二者单独诊断(Z联合vs.SImax=3.999,P<0.001;Z联合vs.SMURF1=3.270,P=0.001).结论 超声造影联合血清SMURF1检测可提高甲状腺癌的诊断效能,可在保证甲状腺癌患者诊断效率的前提下,避免临床甲状腺癌患者的过度诊断.
Objective To investigate the diagnostic value of contrast-enhanced ultrasound(CEUS)combined with serum Smad ubiquitin regulatory factor 1(SMURF1)detection for thyroid cancer.Methods A total of 144 suspected thyroid cancer patients admitted to Lishui branch of Zhongda Hospital Affiliated to Southeast University from February 2019 to February 2020 were selected as the study subjects.Based on the histopathological results,they were divided into the thyroid cancer group(76 cases)and the benign group(68 cases).All patients underwent contrast-enhanced ultrasound examination and serum SMURF1 level detection;the diagnostic value of contrast-enhanced ultrasound parameters,serum SMURF1 detection alone,and the combination of the two methods for thyroid cancer were analyzed.Results Contrast-enhanced ultrasound parameters peak intensity(PI),mean perfusion intensity(SImean)and maximum perfusion intensity(SImax)in the thyroid cancer group were lower than those in the benign group,and the level of SMURF1 mRNA was higher than that in the benign group(P<0.05).The sensitivity of contrast-enhanced ultrasound parameter SImax in the diagnosis of thyroid cancer was 82.89%,the specificity was 72.06%,the accuracy was 77.78%,and the Kappa value was 0.552.The sensitivity of serum SMURF1 in the diagnosis of thyroid cancer was 65.79%,the specificity was 94.12%,the accuracy was 79.17%,and the Kappa value was 0.589.The sensitivity,specificity,accuracy and Kappa value of SImax combined with serum SMURF1 in the diagnosis of thyroid cancer were 97.37%,85.29%,91.67%and 0.832,respectively,which were higher than those of SImax and SMURF1 alone(P<0.05),the AUC of the combination of the two methods was 0.927,which was significantly higher than that of the two methods alone(Zcombined vs.SImax=3.999,P<0.001;Zcombined vs.SMURF1=3.270,P=0.001).Conclusion Contrast-enhanced ultrasound combined with serum SMURF1 detection can improve the diagnostic efficiency of thyroid cancer,which may avoid the over-diagnosis on the premise of ensuring the effective diagnosis of thyroid cancer patients.
汪金;常新;韩春荣;万珂;谌辉;赵静;熊鹃
东南大学附属中大医院溧水分院/南京市溧水区人民医院超声医学科,江苏 南京 211200东南大学附属中大医院溧水分院/南京市溧水区人民医院病理科,江苏 南京 211200悉尼大学医学与健康学院,澳大利亚 新南威尔士 2050
临床医学
甲状腺癌超声造影Smad泛素调节因子1诊断
thyroid cancercontrast-enhanced ultrasoundSmad ubiquitin regulatory factor 1diagnosis
《局解手术学杂志》 2024 (002)
153-157 / 5
江苏省医院协会面上项目(JSYGY-3-2019-504);江苏大学临床医学科技发展基金研究项目(JLY2021165);2023年度江苏大学医教协同创新基金(JDYY2023101)
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