血清TTF-1、MIP-1α水平与甲状腺乳头状微小癌的关系研究

摘要

Objective To analyze the clinical value of serum thyroid transcription factor(TTF-1),macrophage inflam-matory protein 1 alpha(MIP-1 alpha)levels in,papillary thyroid microcarcinoma(PTMC),and provide a new way for the clini-cal diagnosis of PTMC.Methods 42 cases of papillary thyroid cancer(PTC)patients 45 cases of PTMC patients and 40 cases of TD were selected,all patients were confirmed by pathology.All the patients were diagnosed by pathology,and then the fasting ve-nous blood was collected.The serum levels of TTF-1 and MIP-1 were detected by enzyme linked immunosorbent assay(ELISA). Comparison of the 3 groups of patients with serum TTF-1,MIP-1 alpha difference.Combined with the results of pathological diag-nosis,serum TTF-1,MIP-1 alpha levels were made ROC curve to determine the critical value of serum TTF-1,MIP-1 alpha in the 3 groups of patients.According to the critical limit of serum TTF-1,MIP-1 alpha,using different combinations(serum TTF-1,ser-um TTF-1+MIP-1,MIP-1 alpha alpha)make the diagnosis results of PTC,PTMC and TC were calculated for all patients,the ser-um TTF-1,MIP-1 alpha,TTF-1+MIP-1 serum PTMC diagnostic sensitivity,specificity and accuracy of diagnosis,and different schemes were compared.Results There was no significant difference in the 3 groups(P>0.05).The levels of serum TTF-1 and MIP-1 were significantly higher in patients with PTMC and TD(P<0.05).The levels of serum TTF-1 and MIP-1 were signifi-cantly higher in PTMC group than in TD group(P<0.05).Serum TTF-1 index of the ROC curve on the left side of the inflection point(4.3 g/L),serum MIP-1 alpha ROC curve on the left side of the inflection point(ng/L).The sensitivity and specificity of serum TTF-1+MIP-1 in the diagnosis of PTMC were significantly higher than that of serum TTF-1 and MIP-1.Conclusion The serum TTF-1,MIP-1 alpha and thyroid carcinogenesis are closely related.The clinical diagnostic value of serum TTF-1 combined with MIP-1 alpha for PTMC is higher,avoid experience limitation of equipment and personnel in the diagnosis of high -frequency ultrasound,the diagnosis of PTMC has certain clinical value.%目的 探讨TTF-1、MIP-1α在PTMC诊断中的临床价值,为临床PTMC的诊断提供新途径.方法 选择PTC患者42例、PTMC患者45例及TD患者40例做为研究对象,所有患者均经病理确诊.所有患者经病理确诊并入组后,取空腹静脉血,采用酶联免疫法检测血清TTF-1、MIP-1α水平.比较三组患者血清TTF-1、MIP-1α结果差异.结合病理诊断结果,将三组患者的血清TTF-1、MIP-1α水平分别制作ROC曲线,确定三组患者血清TTF-1、MIP-1α的临界限值.根据血清TTF-1、MIP-1α的临界限值,采用不同的组合(血清TTF-1、MIP-1α、血清TTF-1+MIP-1α)对所有患者分别做出PTC、PTMC、TC的诊断结果,计算血清TTF-1、MIP-1α、血清TTF-1+MIP-1α诊断PTMC的灵敏度、特异度和准确度,并比较不同方案的诊断价值.结果 三组患者一般资料比较差异无统计学意义(P>0.05).PTC组患者血清TTF-1、MIP-1α水平均明显高于PTMC和TD患者(P<0.05),PTMC组患者血清TTF-1、MIP-1α水平均高于TD组患者(P<0.05).血清TTF-1指标的ROC曲线左侧拐点为(4.3 μg/L),血清MIP-1αROC曲线左侧拐点为(55.6 ng/L).血清TTF-1+MIP-1α诊断PTMC的灵敏度、特异度均明显高于单纯的血清TTF-1、MIP-1α.结论 血清TTF-1、MIP-1α与甲状腺癌变程度关系密切,血清TTF-1联合MIP-1α诊断PTMC具有较高的临床价值,避免了高频超声诊断的设备和操作人员的经验限制,诊断PTMC具有一定的临床价值.