摘要
目的探讨超声引导下细针穿刺活检(FNA)联合间皮细胞角蛋白-1(HBME-1)、胰岛素样生长因子ⅡmRNA结合蛋白3(IMP-3)在甲状腺结节临床诊断中的应用价值,以减少临床误诊和漏诊。方法取行超声引导下FNA的146例甲状腺结节患者穿刺标本,进行HBME-1、IMP-3免疫细胞化学染色,分析染色结果;以术后病理结果为“金标准”,对比超声引导下FNA联合HBME-1、IMP-3的诊断符合率。结果甲状腺恶性结节组的HBME-1、IMP-3阳性表达率(90.91%、88.89%)高于良性结节组(17.02%、25.53%),超声引导下FNA联合HBME-1、IMP-3的诊断符合率(91.78%)高于超声引导下FNA诊断符合率(78.77%)、IMP-3诊断符合率(84.25%);差异均有统计学意义(P<0.05)。ROC曲线显示,超声引导下FNA联合HBME-1、IMP-3诊断甲状腺结节的AUC为0.895,高于三者单独诊断(0.765、0.869、0.817),差异有统计学意义(P<0.05)。结论超声引导下FNA联合HBME-1、IMP-3,有助于提高甲状腺结节的临床诊断率。
Objective The aim of this study is to investigate the clinical application value of ultrasound-guided fine needle aspiration(FNA)combined with mesothelial cell keratin-1(HBME-1)and insulin-like growth factor II mRNA binding protein 3(IMP-3)in the diagnosis of thyroid nodules,aiming to minimize instances of clinical misdiagnosis and missed diagnosis.Methods Puncture specimens were collected from 146 patients with thyroid nodules who underwent ultrasound-guided fine-needle aspiration(FNA)for chemical staining of HBME-1 and IMP-3,and the staining results were analyzed.The diagnostic accuracy of ultrasound-guided FNA combined with HBME-1 and IMP-3 was compared to postoperative pathological results as the gold standard.Results The positive expression rates of HBME-1 and IMP-3 in the malignant thyroid nodule group were 90.91%and 88.89%,respectively,which were significantly higher than those in the benign thyroid nodule group(17.02%and 25.53%).Ultrasound-guided FNA combined with HBME-1 and IMP-3 showed a diagnostic coincidence rate of 91.78%,which was significantly higher than that of ultrasound-guided FNA alone or combined with IMP-3 alone(78.77%and 84.25%,respectively)(P<0.05).The ROC curves demonstrated that the AUC of ultrasound-guided FNA combined with HBME-1 and IMP-3 for diagnosing thyroid nodules was 0.895,which was significantly higher than that of any single index(0.765,0.869,0.817)with a statistically significant difference(P<0.05).Conclusions Ultrasound-guided FNA in combination with the use of HBME-1 and IMP-3 markers is a valuable approach to enhance the clinical diagnostic accuracy of thyroid nodules.
作者
鲁小飞
何暐
王福建
LU Xiaofei;HE Wei;WANG Fujian(Department of Ultrasound,Hangzhou Ninth People’s Hospital,Hangzhou 311225,China)
出处
《健康研究》
CAS
2023年第4期459-462,共4页
Health Research
