| 超声联合Galectin-3、CK19诊断甲状腺乳头状癌的准确性 |
| 投稿时间：2016-04-04 修订日期：2016-04-29 点此下载全文 |
| 引用本文：贾丽琼,潘炯,李小强.超声联合Galectin-3、CK19诊断甲状腺乳头状癌的准确性[J].医学研究杂志,2016,45(12):80-84 |
| DOI：
10.11969/j.issn.1673-548X.2016.12.022 |
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| 基金项目:上海市宝山区区科委基金资助项目（14-E-13） |
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| 中文摘要:目的 探讨超声联合Galectin-3、CK19诊断甲状腺乳头状癌（papillary thyroid carcinoma，PTC）的准确性。方法 收集甲状腺结节病例150例，其中PTC 66例分为PTC组，结节性甲状腺肿（nodular goiter，NG）84例分为NG组。对两组的超声特征进行比较；以病理组织的检测为标准，分析以FNAC的标本检测CK19和Galectin-3的表达情况的敏感度、特异性和准确性；应用ROC曲线统计分析患者结节的TI-RADS分类、CK19和Galectin-3的表达分级的情况，比较超声、CK19、Galectin-3单独或联合诊断PTC的ROC曲线下面积（area under curve，AUC），分析约登指数最高时的敏感度和特异性。结果 PTC组出现边界不清、内部回声低、微钙化以及血流达3级的超声特征均较NG组显著，差异有统计学意义（P<0.05）；FNAC检测CK19、Galectin-3表达的的敏感度、特异性、准确性分别为90.16%、87.50%、89.51%和87.85%、87.270%、87.65%。单独超声、CK19或Galectin-3诊断NG、PTC的AUC分别为0.846、0.829、0.785，三者诊断效能均为中等水平；而联合超声、CK19和Galectin-3诊断NG和PTC的AUC为0.904，诊断效能较高，其敏感度为83.3%、特异性为79.6%时约登指数可达0.629。结论 术前对超声引导穿刺的标本进行CK19和Galectin-3表达强度的检测结合超声检查结果有助于提高对于PTC和NG的鉴别和诊断。 |
| 中文关键词:超声 Galectin-3 CK19 甲状腺乳头状癌 |
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| Accuracy of Ultrasound Combined with Galectin-3,CK19 Accuracyto Diagnose Papillary Thyroid Carcinoma |
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| Abstract:Objective To explore the accuracy of ultrasound combined with Galectin-3, CK19 accuracy to diagnose papillary thyroid carcinoma(PTC).Methods One hundred and fifty cases of thyroid nodule were collected, of which 66 cases of PTC were divided into PTC groups, 84 cases of nodular goiter(NG) were divided into NG groups. A comparison was carried on the ultrasound characteristics of the two groups. Pathological tissue was detected and used as the standard. The expression of CK19 and Galectin-3 in FNAC specimens were detected, and their sensitivity, specificity and accuracy were analyzed. Nodule TI-RADS classification,CK19 and Galectin-3 expression grade of patients were counted and compared by ROC curve. The area under curve(AUC) of ultrasound, CK19, Galectin-3, alone or combined to diagnosis PTC were compared and the sensitivity and specificity of the highest Youden's index were analyzed.Results The sonographic features of ill-defined, low internal echo, microcalcifications and bloodstream reached three in the PTC group were significantly more than those in NG group. The difference was statistically significant (P<0.05).The sensitivity, specificity and accuracy of CK19 and Galectin-3 expression in FNAC specimens were 90.16%, 87.50%, 89.51% and 87.85%, 87.27%, 87.65%, respectively. The AUC of ultrasound, CK19 or Galectin-3 alone to diagnostic NG or PTC were 0.846,0.829,0.785. All of their diagnostic performance were moderate level.However,the AUC of combined ultrasound, CK19 and Galectin-3 to diagnostic NG or PTC were 0.904,the diagnostic efficiency was higher. And the sensitivity and specificity were 83.3% and 79.6% when Youden's index up to 0.629.Conclusion In the preoperative, detection of CK19 and Galectin-3 expression intensity in ultrasound-guided biopsy specimens combined with ultrasound results will help to improve the identification and diagnosis of PTC and NG. |
| keywords:Ultrasound Galectin-3 CK19 Papillary thyroid carcinoma |
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