彩超联合血清FGF-19、KLF4检测对甲状腺结节良恶性的诊断价值

Diagnostic value of color Doppler ultrasound combined with serum FGF-19 and KLF4 in benign and malignant thyroid nodules

摘要:

目的 探究彩色多普勒超声(彩超)联合血清成纤维细胞生长因子19(FGF-19)、Krüppel样因子4(KLF4)检测对甲状腺结节良恶性的诊断价值。方法 选取河南中医药大学第三附属医院2021年2月至2024年2月收治的98例甲状腺结节患者作为研究对象，依据病理诊断结果区分结节的良恶性，分为良性组(61例)及恶性组(37例)。酶联免疫吸附法(ELISA)检测血清FGF-19、KLF4水平，彩超记录超声图像特征，受试者工作特征曲线(ROC)分析血清FGF-19、KLF4水平单独诊断恶性甲状腺结节的诊断价值，Kappa检验分析彩超及彩超联合血清FGF-19、KLF4水平诊断与病理诊断结果的一致性，四格表法分析彩超联合血清FGF-19、KLF4水平诊断恶性甲状腺结节的诊断效能。结果 恶性组血清FGF-19水平高于良性组，血清KLF4水平低于良性组(P<0.05),两组低回声、血流分级、钙化灶、淋巴结肿大、包膜侵犯、声晕完整、声晕规则、边界清晰及形态规则比较，差异有统计学意义(P<0.05)。彩超联合血清FGF-19、KLF4水平诊断恶性甲状腺结节的Kappa值高于彩超单独诊断恶性甲状腺结节的Kappa值。彩超联合血清FGF-19、KLF4水平诊断甲状腺恶性结节的敏感度、准确度及阴性预测概率高于单个指标单独检测，漏诊率低于单个指标单独检测。结论 彩超联合血清FGF-19、KLF4水平为临床鉴别甲状腺结节的良恶性提供一定的参考价值。

Abstract:

Objective ToexplorethediagnosticvalueofcolorDopplerultrasound (CDUS)combined withserum fibroblastgrowthfactor19(FGF-19)andKrüppel-likefactor4(KLF4)detectionforbenignandmalignantthyroidnodules. Methods Atotalof98patientswiththyroidnodulesadmittedtotheThird Affiliated Hospitalof Henan Universityof TraditionalChinese Medicinefrom February2021toFebruary2024 wereincludedastheresearchobjects.They were classifiedintoabenigngroup(n=61)anda malignantgroup (n=37)basedonthepathologicalresultsofthenodules. Enzyme-linkedimmunosorbentassay(ELISA)wasutilizedtodetectserumFGF-19andKLF4levels.Theincludedpatients underwentCDUSandtheultrasoundimagefeatureswererecorded.Receiveroperatingcharacteristic (ROC)curveswere plottedtoanalyzethediagnosticvalueofserum FGF-19orKLF4levelaloneinthediagnosisofmalignantthyroidnodules. KappatestwasappliedtoanalyzetheconsistencybetweenthediagnosticresultsofCDUSandCDUScombinedwithserum FGF-19andKLF4levelsandpathologicaldiagnosis.Thefourfoldtablemethodwasappliedtoanalyzethediagnosticefficacy ofCDUScombinedwithserumFGF-19orKLF4levelofmalignantthyroidnodules.Results TheserumFGF-19levelinthe malignantgroupwashigherthanthatinthebenigngroup,whiletheserumKLF4levelinthemalignantgroupwaslowerthan thatin the benign group (P < 0.05). There were significant differences between the two groupsin terms of hypoechogenicity,bloodflow grading,calcifiedlesions,lymphnodeenlargement,capsuleinvasion,intactacoustichalo, regularacoustichalo,clearboundaries,andregularmorphology (P <0.05).TheKappavalueofCDUScombinedwith serumFGF-19and KLF4levelsindiagnosing malignantthyroid washigherthanthatofCDUSalone.Thesensitivity, accuracy,andnegativepredictiveprobabilityofCDUScombinedwithserumFGF-19andKLF4levelswerehigherthanthose ofsingleindicator,whilethemisseddiagnosisratewaslowerthanthatofsingleindicator.Conclusion CDUScombinedwith serumFGF-19andKLF4levelsprovidescertainreferencevalueforclinicaldifferentiationofbenignandmalignantthyroid nodules.