高频超声联合血清microRNA-599、Galectin-3在乳头状甲状腺癌颈部淋巴结转移中的预测价值

Predictive value of high-frequency ultrasound combined with serum microRNA-599 and galectin-3 for cervical lymph node metastasis in papillary thyroid carcinoma

摘要:

目的 探讨高频超声联合血清microRNA-599（miR-599）、半乳糖凝集素-3（Galectin-3）在乳头状甲状腺癌（PTC）颈部淋巴结转移中的预测价值。方法 选取2021年3月—2024年3月北京中医药大学孙思邈医院80例临床诊断为PTC的患者，以病理学诊断作为“金标准”，根据患者是否发生颈部淋巴结转移分为：阳性组（有淋巴结转移35例）和阴性组（无淋巴结转移45例）。所有患者进行高频超声诊断及血清miR-599、Galectin-3水平检测，评估高频超声诊断价值并比较两组血清miR-599、Galectin-3水平，使用受试者工作特征（ROC）曲线评估其对PTC颈淋巴结转移的预测效能。结果 80例PTC患者中，病理学诊断阳性35例，阴性45例，高频超声诊断阳性42例，阴性38例。高频超声诊断的敏感性为80.0%（28/35），特异性为68.9%（31/45）。阳性组血清miR-599水平低于阴性组（P <0.05），Galectin-3水平高于阴性组（P <0.05）。ROC曲线结果表明，3者联合检测诊断PTC颈部淋巴结转移的敏感性为97.1%（95% CI：0.851，0.999），特异性为80.0%（95% CI：0.654，0.904），AUC为0.942（95% CI：0.894，0.990）。结论 高频超声结合血清miR-599和Galectin-3检测对PTC颈淋巴结转移的诊断更准确，优于单独检测，能更准确地预测颈部淋巴结转移的风险。

Abstract:

Objective To explore the predictive value of high-frequency ultrasound combined with serum microRNA-599 (miR-599) and galectin-3 for cervical lymph node metastasis in papillary thyroid carcinoma (PTC).Methods A total of 80 patients clinically diagnosed with PTC at Sun Simiao Hospital, Beijing University of Chinese Medicine, from March 2021 to March 2024 were enrolled. Pathological diagnosis was used as the gold standard. According to the presence of cervical lymph node metastasis, patients were divided into a positive group (n = 35) and a negative group (n = 35). All patients underwent high-frequency ultrasound and serum testing for miR-599 and galectin-3 levels. The diagnostic value of high-frequency ultrasound was evaluated, and serum biomarker levels were compared between groups. The diagnostic efficacy of these indicators for cervical lymph node metastasis in PTC was assessed using receiver operating characteristic (ROC) curves.Results Among the 80 PTC patients, 35 were pathologically confirmed to have cervical lymph node metastasis, and 45 had no metastasis. High-frequency ultrasound identified 28 positive cases and 31 negative cases, with a sensitivity of 80.0% (28/35) and specificity of 68.9% (31/45). Serum miR-599 levels were significantly lower and galectin-3 levels were significantly higher in the positive group compared to the negative group (P < 0.05). The sensitivity and specificity of the combined detection of the three indicators for diagnosing cervical lymph node metastasis in PTC were 97.1% (95% CI: 0.851, 0.999) and 80.0% (95% CI: 0.654, 0.904), respectively, with an area under the curve of 0.942 (95% CI: 0.894, 0.990).Conclusion High-frequency ultrasound combined with serum miR-599 and galectin-3 provides more accurate diagnosis of cervical lymph node metastasis in PTC than individual methods, offering a more precise assessment of metastatic risk.