天津医药

天津医药 ›› 2021, Vol. 49 ›› Issue (7): 731-735.doi: 10.11958/20203017

• 临床研究 • 上一篇    下一篇

miR-155联合超声对分化型甲状腺癌淋巴结转移的诊断价值分析

许卫国，全江涛，周娟，张智林，廖扬，陈蕊   

  1. 1解放军南部战区总医院干部病房（邮编510010），2放射科，3肿瘤科，4超声科，5检验科，6呼吸内科
  • 收稿日期:2020-11-02 修回日期:2021-03-12 出版日期:2021-07-15 发布日期:2021-07-12
  • 作者简介:许卫国（1975），男，硕士，副主任医师，主要从事甲状腺疾病及糖尿病的优化诊治方面研究。E-mail：xwg197504@163.com
  • 基金资助:
    广东省自然科学基金资助项目（2018A030313787）

The diagnostic value of miR-155 combined with ultrasound in lymph node metastasis of differentiated thyroid carcinoma

XU Wei-guo, QUAN Jiang-tao, ZHOU Juan, ZHANG Zhi-lin, LIAO Yang, CHEN Rui   

  1. 1 Department of Cadre Ward, 2 Department of Radiology, 3 Department of Oncology, 4 Department of Ultrasound, 5 Department of Laboratory, 6 Department of Respiratory Medicine, the General Hospital of the Southern Theater of the Chinese People's Liberation Army, Guangzhou 510010, China
  • Received:2020-11-02 Revised:2021-03-12 Published:2021-07-15 Online:2021-07-12

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摘要： 目的　探讨微小RNA-155（miR-155）联合超声对分化型甲状腺癌淋巴结转移的诊断价值。方法　选取接受治疗的分化型甲状腺癌患者112例作为甲状腺癌组，另选取同期收治的结节性甲状腺肿患者30例作为良性对照组。采用实时荧光定量PCR（qPCR）检测2组患者血清及组织中miR-155的相对表达量，分析分化型甲状腺癌患者血清及组织中miR-155的表达与临床病理参数的关系。采用受试者工作特征（ROC）曲线分析术前超声以及血清miR-155对分化型甲状腺癌淋巴结转移的诊断价值。结果　甲状腺癌组的血清及组织中miR-155的相对表达量均明显高于良性对照组（P＜0.01），有淋巴结转移、肿瘤直径＞2 cm、TNM分期Ⅲ+Ⅳ期的患者血清及组织中miR-155的相对表达量分别高于无淋巴结转移、肿瘤直径≤2 cm、TNM分期Ⅰ+Ⅱ期的患者（均P＜0.05）。ROC结果显示，超声以及血清miR-155对分化型甲状腺癌淋巴结转移均有一定的诊断价值，曲线下面积分别为：0.839（95%CI：0.760～0.919）、0.837（95%CI：0.763～0.912），但漏诊率和误诊率均超过10%。两者联合应用后对分化型甲状腺癌淋巴结转移的诊断价值可得到进一步的提升，曲线下面积为0.912（95%CI：0.851～0.973），漏诊率和误诊率也降至10%以下。结论　血清miR-155联合超声对分化型甲状腺癌淋巴结转移的诊断价值较高，具有一定的临床应用价值。

关键词: 甲状腺肿瘤, 淋巴转移, 超声检查, 微RNAs, ROC曲线, 分化型甲状腺癌, 微小RNA-155

Abstract: Objective　To investigate the value of microRNA-155 (miR-155) combined with ultrasound in the diagnosis of lymph node metastasis in differentiated thyroid carcinoma. Methods　A total of 112 patients with differentiated thyroid cancer who were treated in our hospital were selected as thyroid cancer group, and 30 patients with nodular goiter in the same period were selected as benign control group. Real time quantitative PCR (qPCR) was used to detect the relative expression of miR-155 in serum and tissue in the two groups of patients. The relationship between the expression of miR-155 in serum and tissue of patients with differentiated thyroid cancer and clinical pathological parameters was analyzed. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of preoperative ultrasound and serum miR-155 for lymph node metastasis of differentiated thyroid cancer. Results　The relative expressions of miR-155 in serum and tissue were significantly higher in thyroid cancer group than those in benign control group (P＜0.01). The relative expression levels of miR-155 in serum and tissue were significantly higher in patients with lymph node metastasis, tumor size＞2 cm and TNM stage Ⅲ+Ⅳ than those in patients without lymph node metastasis, tumor size≤ 2 cm and TNM stageⅠ+Ⅱ (all P＜0.05). ROC results showed that ultrasound and serum miR-155 had certain diagnostic value for lymph node metastasis of differentiated thyroid carcinoma. The area under the curve was 0.839 (95%CI: 0.760-0.919) and 0.837 (95%CI: 0.763-0.912), respectively. But the missed diagnosis rate and misdiagnosis rate were more than 10%. The combined application of the two methods could further improve the diagnostic value of lymph node metastasis of differentiated thyroid cancer, the area under the curve was 0.912 (95%CI: 0.851-0.973), and the missed diagnosis rate and misdiagnosis rate were also reduced to less than 10%. Conclusion　The serum miR-155 combined with ultrasound has high diagnostic value for the lymph node metastasis of differentiated thyroid carcinoma, which has certain clinical application value.

Key words: thyroid neoplasms, lymphatic metastasis, ultrasonography, microRNAs, ROC curve, differentiated thyroid carcinoma, microRNA-155