PDF(Pubmed)
Abstract：
BACKGROUND: This study aims to investigate the role of shear wave elastography (SWE) and connective tissue growth factor (CTGF) in the assessment of papillary thyroid carcinoma (PTC) prognosis.
METHODS: CTGF expression was detected with immunohistochemistry. Clinical and pathological data were collected. Parameters of conventional ultrasound combined with SWE were also collected. The relationship among CTGF expression, ultrasound indicators, the elastic modulus and the clinicopathological parameters were analyzed.
RESULTS: Univariate analysis showed that patients with high risk of PTC were characterized with male, Uygur ethnicity, increased expression of CTGF, convex lesions, calcified, incomplete capsule, intranodular blood flow, rear echo attenuation, cervical lymph node metastasis, lesions larger than 1 cm, psammoma bodies, advanced clinical stage, increased TSH and high value in the shear modulus (P < 0.05). Multivariate analysis demonstrated that the risk factors of high expression of CTGF according to contribution size order were irregular shape, aspect ratio ≥ 1, and increased TSH. The logistic regression model equation was Logit (P) = 1.153 + 1.055 × 1 + 0.926 × 2 + 1.190 × 3 and the Area Under Curve value of the logistic regression was calculated to be 0.850, with a 95% confidence interval of 0.817 to 0.883.
CONCLUSIONS: SWE and CTGF are of great value in the risk assessment of PTC. The degree of fibrosis of PTC is closely related to the prognosis. The hardness of PTC lesions and the expression level of CTGF are correlated with the main indexes of conventional ultrasound differentiating benign or malignant nodules. Irregular shape, aspect ratio ≥ 1, and increased TSH are independent factors of CTGF.
METHODS: CTGF expression was detected with immunohistochemistry. Clinical and pathological data were collected. Parameters of conventional ultrasound combined with SWE were also collected. The relationship among CTGF expression, ultrasound indicators, the elastic modulus and the clinicopathological parameters were analyzed.
RESULTS: Univariate analysis showed that patients with high risk of PTC were characterized with male, Uygur ethnicity, increased expression of CTGF, convex lesions, calcified, incomplete capsule, intranodular blood flow, rear echo attenuation, cervical lymph node metastasis, lesions larger than 1 cm, psammoma bodies, advanced clinical stage, increased TSH and high value in the shear modulus (P < 0.05). Multivariate analysis demonstrated that the risk factors of high expression of CTGF according to contribution size order were irregular shape, aspect ratio ≥ 1, and increased TSH. The logistic regression model equation was Logit (P) = 1.153 + 1.055 × 1 + 0.926 × 2 + 1.190 × 3 and the Area Under Curve value of the logistic regression was calculated to be 0.850, with a 95% confidence interval of 0.817 to 0.883.
CONCLUSIONS: SWE and CTGF are of great value in the risk assessment of PTC. The degree of fibrosis of PTC is closely related to the prognosis. The hardness of PTC lesions and the expression level of CTGF are correlated with the main indexes of conventional ultrasound differentiating benign or malignant nodules. Irregular shape, aspect ratio ≥ 1, and increased TSH are independent factors of CTGF.
摘要：
背景：本研究旨在探讨剪切波弹性成像（SWE）和结缔组织生长因子（CTGF）在甲状腺乳头状癌（PTC）预后评估中的作用。
方法：免疫组化法检测CTGF的表达。收集临床和病理资料。还收集了常规超声结合SWE的参数。CTGF表达之间的关系，超声指标,分析弹性模量和临床病理参数。
结果：单因素分析显示，PTC高危患者以男性为特征，维吾尔族,CTGF的表达增加，凸性病变,钙化,不完整的胶囊，结节内血流,后回波衰减，颈淋巴结转移，病灶大于1厘米，沙玛尸体,晚期临床阶段，TSH升高，剪切模量值较高（P<0.05）。多因素分析显示CTGF高表达的危险因素按贡献大小排序为不规则形状,纵横比≥1，TSH升高。Logistic回归模型方程为Logit(P)=1.153+1.055×1+0.926×2+1.190×3,Logistic回归曲线下面积值为0.850,95%置信区间为0.817~0.883。
结论：SWE和CTGF在PTC的风险评估中具有重要价值。PTC纤维化程度与预后密切相关。PTC病灶的硬度和CTGF的表达水平与常规超声鉴别良恶性结节的主要指标相关。不规则形状,纵横比≥1和TSH升高是CTGF的独立因素。
方法：免疫组化法检测CTGF的表达。收集临床和病理资料。还收集了常规超声结合SWE的参数。CTGF表达之间的关系，超声指标,分析弹性模量和临床病理参数。
结果：单因素分析显示，PTC高危患者以男性为特征，维吾尔族,CTGF的表达增加，凸性病变,钙化,不完整的胶囊，结节内血流,后回波衰减，颈淋巴结转移，病灶大于1厘米，沙玛尸体,晚期临床阶段，TSH升高，剪切模量值较高（P<0.05）。多因素分析显示CTGF高表达的危险因素按贡献大小排序为不规则形状,纵横比≥1，TSH升高。Logistic回归模型方程为Logit(P)=1.153+1.055×1+0.926×2+1.190×3,Logistic回归曲线下面积值为0.850,95%置信区间为0.817~0.883。
结论：SWE和CTGF在PTC的风险评估中具有重要价值。PTC纤维化程度与预后密切相关。PTC病灶的硬度和CTGF的表达水平与常规超声鉴别良恶性结节的主要指标相关。不规则形状,纵横比≥1和TSH升高是CTGF的独立因素。
