Department of Ultrasound, The No. 1 People's Hospital of Yongkang, Yongkang, China.
Department of Ultrasound, Sir Run Run Shaw Hospital, Zhejiang University, Hangzhou, China.
Dis Markers. 2022 Mar 2;2022:9980185. doi: 10.1155/2022/9980185. eCollection 2022.
Early cervical lymph node (LN) metastasis is an important cause of poor survival in patients with medullary thyroid cancer (MTC). This study evaluated whether the preoperative serum calcitonin level in combination with ultrasonographic features of MTC can be used to assess the LN status as well as predict the risk of metastasis in patients with MTC.
We retrospectively analyzed the clinical data of 95 patients with MTC, and a nomogram model was constructed and validated. Using integrated database analysis of The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx), we mined pathways wherein is involved, identified calcitonin-related genes, and analyzed their functions.
Correlation analysis revealed a significant association between the infiltrating range, diameter, calcification, blood flow, the preoperative serum calcitonin level, and metastasis. The metastasis risk-prediction model showed great accuracy in determining the risk of metastasis in MTC (area under the curve of the receiver operating characteristic [ROC] curve: 0.979 [95% confidence interval 0.946-1.000]). Decision curve analysis (DCA) showed that the model has excellent clinical utilization potential. Significantly, , the mRNA for calcitonin, was highly expressed in thyroid cancer tissues and associated with the cytokine-cytokine receptor and neuroactive ligand-receptor interaction pathways as well as the cell-adhesion molecules. ROC curve indicated that the , , , and genes, which are related to the cytokine-cytokine receptor interaction pathway, could indicate the risk of metastasis in MTC.
The preoperative serum calcitonin level, in combination with ultrasonographic features, can be used to predict the risk of metastasis in patients with MTC and constitute a noninvasive accurate method for preoperative diagnosis of MTC.
早期颈淋巴结（LN）转移是影响甲状腺髓样癌（MTC）患者生存的重要原因。本研究评估术前降钙素水平联合 MTC 的超声特征是否可用于评估 LN 状态并预测 MTC 患者的转移风险。
我们回顾性分析了 95 例 MTC 患者的临床资料，并构建和验证了列线图模型。我们通过癌症基因组图谱（TCGA）和基因型组织表达（GTEx）的综合数据库分析，挖掘涉及的途径，确定降钙素相关基因，并分析其功能。
相关性分析显示，浸润范围、直径、钙化、血流、术前降钙素水平与转移均有显著相关性。转移风险预测模型在确定 MTC 转移风险方面具有很高的准确性（受试者工作特征曲线下面积[ROC 曲线]：0.979[95%置信区间 0.946-1.000]）。决策曲线分析（DCA）表明该模型具有很好的临床应用潜力。值得注意的是，降钙素的 mRNA，在甲状腺癌组织中高表达，与细胞因子-细胞因子受体和神经活性配体-受体相互作用途径以及细胞黏附分子有关。ROC 曲线表明，与细胞因子-细胞因子受体相互作用途径相关的 、 、 、 基因可提示 MTC 转移风险。
术前降钙素水平联合超声特征可用于预测 MTC 患者的转移风险，构成了一种非侵入性的术前诊断 MTC 的准确方法。
