超声检查联合基质金属蛋白酶检测对甲状腺癌的诊断价值

摘要

Objective:To research the clinical value of ultrasonography combined with matrix metalloproteinases (MMPs)in the diagnosis of thyroid carcinoma.Methods:All 476 cases of thyroid nodule patients in our hospital were selected as the research objects.Among them,63 cases of thyroid carcinoma and 413 cases of benign nodules,to ob-serve the ultrasonographic manifestations of two groups of patients,compared serum MMP -2 and MMP -9 levels,and the accuracy,sensitivity and specificity of the two methods in the diagnosis of thyroid cancer.Results:There were sig-nificant differences in the differential diagnosis of benign and malignant thyroid nodules with no coating,low echo,mi-cro calcification and cystic degeneration(P <0.05).The elasticity images of the patients with thyroid cancer were more than 3 ~4,while the scores of the patients with benign nodules was more than 0 ~2,and the difference was sta-tistically significant(P <0.05).The average MMP -2 and MMP -9 in the thyroid carcinoma group was significantly higher than those in the benign nodule group(P <0.05).In the differential diagnosis of benign and malignant thyroid nodules,the positive rate and the negative rate of MMPs diagnosis of thyroid carcinoma were significantly higher than that in the diagnosis of thyroid carcinoma(P <0.05).The accuracy,sensitivity and specificity of ultrasound combined with MMPs in the diagnosis of thyroid carcinoma were 85.50%,90.48% and 84.75% respectively,were superior to ultrasound diagnosis(73.32%,76.19%,72.88%),the differences were statistically significant(P <0.05).Conclu-sion:Elastography is of certain clinical value in the diagnosis of thyroid carcinoma,matrix metalloproteinases play an important role in the invasion and metastasis of thyroid carcinoma,the over expression can be used as a prognostic in-dicator in patients with thyroid carcinoma,the diagnosis of thyroid carcinoma by elastography combined with matrix metalloproteinases can significantly improve the diagnostic accuracy of thyroid carcinoma.%目的：探讨超声检查联合基质金属蛋白酶（MMPs）检测诊断甲状腺癌的临床价值。方法：我院收治的476例甲状腺结节患者为研究对象，其中甲状腺癌63例，良性结节者413例。分别对两组患者进行超声弹性成像检查和基质金属蛋白酶检测。观察两组患者的超声表现，对两组患者的血清 MMP －2、MMP －9水平进行比较，并对超声检查以及超声联合基质金属蛋白酶检测两种检查方式在诊断甲状腺癌上的准确度、敏感度及特异度进行对比性分析。结果：从超声结果来看，无包膜、低回声、微钙化和囊性变在鉴别甲状腺良恶性结节上存在显著性差异（P ＜0．05）。甲状腺癌患者的弹性图像上多表现为3～4分，而良性结节组患者的评分多在0～2分，组间差异比较有统计学意义（P ＜0．05）。甲状腺癌组的 MMP －2、MMP －9水平均显著高于良性结节组，组间比较有显著性差异（P ＜0．05）。在鉴别甲状腺良恶性结节上，超声联合基质金属蛋白酶诊断甲状腺癌的阳性率和诊断良性结节的阴性率均明显高于超声诊断（P ＜0．05）。而超声联合基质金属蛋白酶诊断甲状腺癌上的准确度、敏感度和特异度分别为85．50％、90．48％、84．75％，均优于超声诊断（73．32％、76．19％、72．88％），差异有统计学意义（P ＜0．05）。结论：超声弹性成像对于鉴别甲状腺癌具有一定临床价值，而基质金属蛋白酶在甲状腺癌的侵袭转移过程中发挥较为重要的作用，其过度表达能够作为甲状腺癌患者的预后指标，通过超声弹性成像联合基质金属蛋白酶检测能够显著提高甲状腺癌的诊断准确性。