| 姚 尉,李成杰,刘 伟,陈志西,张光宇.MSCT、DWI结合IL-10及CXCR7鉴别甲状腺乳头状癌与甲状腺腺瘤的诊断价值研究[J].,2023,(3):539-544 |
| MSCT、DWI结合IL-10及CXCR7鉴别甲状腺乳头状癌与甲状腺腺瘤的诊断价值研究 |
| Diagnostic Value of MSCT, DWI Combined with IL-10 and CXCR7 in Differentiating Papillary Thyroid Carcinoma and Thyroid Adenoma |
| 投稿时间：2022-05-10 修订日期：2022-05-31 |
| DOI：10.13241/j.cnki.pmb.2023.03.028 |
| 中文关键词: MSCT DWI IL-10 CXCR7 甲状腺乳头状癌 甲状腺腺瘤 诊断价值 |
| 英文关键词: MSCT DWI IL-10 CXCR7 Papillary thyroid carcinoma Thyroid adenoma Diagnostic value |
| 基金项目:四川省科技计划项目（2019YFS0444） |
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| 中文摘要: |
| 摘要 目的：探讨多层螺旋计算机断层扫描（MSCT）、弥散加权成像（DWI）结合白介素-10（IL-10）及趋化因子受体7（CXCR7）对甲状腺乳头状癌（PTC）和甲状腺腺瘤（TA）的鉴别诊断效能以及最佳诊断方式。方法：纳入我院2019年3月至2021年10月甲状腺乳头状癌患者55例，甲状腺腺瘤患者32例。所有患者术前行MSCT、磁共振DWI影像检查，术后获取肿瘤组织，通过免疫组织化学方法检测肿瘤组织中IL-10及CXCR7表达情况。采用独立样本t检验比较两组间磁共振DWI、IL-10及CXCR7差异。应用ROC曲线比较磁共振DWI不同b值（300、500、800 s/mm2）对应的ADC值的诊断效能。分别对比MSCT、磁共振DWI、IL-10及CXCR7单独和联合检测对甲状腺乳头状癌与甲状腺腺瘤鉴别的诊断效能。结果：PTC组ADC值均低于TA组（P＜0.05）。当b值=500 s/mmP，PTC组和TA组ADC值分别为（1.509±0.546）×10-3 mm/s和（2.477±0.667）×10-3 mm/s，ROC曲线分析具有最佳诊断效能。当ADC截断值取1.529×10-3 s/mmP时，其曲线下面积（AUC）为0.864（95％CI：0.783～0.945；P＜0.05）。IL-10、CXCR7在PTC组阳性表达率分别为81.82%、72.73%，均高于TA组6.25%、15.63%（P＜0.05）。所有CT征象（形态，边缘，密度，囊变，强化方式，增强后边界模糊与缩小改变，淋巴结肿大情况）在两组间均有差异（P＜0.05）。相比于单项检查方式，MSCT、磁共振DWI结合IL-10及CXCR7检查方式具有最高的敏感度89.09%、特异度88%、阳性预测值98.0%、阴性预测值83.78%、准确率91.95%以及约登指数0.860。结论：b=500 s/mm2的ADC值具有最高的诊断效能，相对于单一检查方式，MSCT、磁共振DWI结合IL-10及CXCR7对鉴别甲状腺乳头状癌与甲状腺腺瘤具有更优的诊断价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore multislice spiral computed tomography (MSCT), diffusion weight image (DWI) combined with interleukin-10 (IL-10) and chemokine receptor 7 (CXCR7) in the differential diagnosis efficiency and the best diagnosis method of papillary thyroid carcinoma (PTC) and thyroid adenoma (TA). Methods: 55 patients with papillary thyroid carcinoma and 32 patients with thyroid adenoma who were included in our hospital from March 2019 to October 2021. All patients underwent MSCT and magnetic resonance DWI imaging before operation, and tumor tissues were obtained after operation, the expression of IL-10 and CXCR7 in tumor tissues were detected by immunohistochemical method. The differences of magnetic resonance DWI, IL-10 and CXCR7 between the two groups were compared by independent sample t-test. The diagnostic efficiency of ADC values corresponding to different b values (300, 500 and 800 s/mm2) of magnetic resonance DWI were compared by ROC curve. The diagnostic efficacy of MSCT, magnetic resonance DWI, IL-10 and CXCR7 alone and in combination in differentiating papillary thyroid carcinoma from thyroid adenoma were compared. Results: The ADC values of the PTC group were all lower than those of the TA group(P＜0.05). When the b value=500 s/m2, the ADC values of the PTC group and the TA group were (1.509±0.546)×10-3 mm/s and (2.477±0.667)×10-3 mm/s, and the ROC curve analysis had the best diagnostic efficiency, When the ADC cutoff value was 1.529×10-3 s/mm, the area under the curve (AUC) was 0.864 (95％CI:0.783～0.945, P＜0.05). The positive expression rates of IL-10 and CXCR7 of the PTC group were 81.82% and 72.73%, which were higher than those of the TA group (6.25% and 15.63%)(P＜0.05). All CT signs (form, edge, density, cystic change, reinforcement mode, edge blur and zoom out changed after enhancement, lymphadenopathy) were different between the two groups(P<0.05). Compared with single examination method, MSCT, magnetic resonance DWI combined with IL-10 and CXCR7 had the highest sensitivity of 89.09%, specificity of 88%, positive predictive value of 98.0%, negative predictive value of 83.78%, accuracy rate of 91.95% and yoden index of 0.860. Conclusion: The ADC value of b=500 s/mm2 has the highest diagnostic efficacy, Compared with single examination method, MSCT and magnetic resonance DWI combined with IL-10 and CXCR7 have better diagnostic value of papillary thyroid carcinoma and thyroid adenoma. |
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