Department of Ultrasonography, The Tenth Affiliated Hospital of Southern Medical University(Dongguan People's Hospital), Dongguan, Guangdong, P.R. China.
Department of Ultrasound, The Affiliated Tumor Hospital of Xinjiang Medical University, Urumqi, 830011, P.R. China.
BMC Med Imaging. 2024 Jul 12;24(1):173. doi: 10.1186/s12880-024-01354-w.
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.
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.
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.
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.
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）在评估甲状腺乳头状癌（PTC）预后中的作用。
采用免疫组织化学法检测 CTGF 表达。收集临床和病理资料。还收集了常规超声联合 SWE 的参数。分析 CTGF 表达、超声指标、弹性模量与临床病理参数之间的关系。
单因素分析显示，PTC 高危患者的特征为男性、维吾尔族、CTGF 表达增加、凸性病变、钙化、不完全包膜、结节内血流、后方回声衰减、颈淋巴结转移、病灶大于 1cm、砂粒体、临床分期较晚、TSH 升高及剪切波模量值较高（P<0.05）。多因素分析表明，按贡献大小顺序，CTGF 高表达的危险因素为不规则形状、纵横比≥1 和 TSH 升高。逻辑回归模型方程为 Logit（P）=1.153+1.055×1+0.926×2+1.190×3，逻辑回归的曲线下面积值计算为 0.850，95%置信区间为 0.817 至 0.883。
SWE 和 CTGF 对 PTC 的风险评估具有重要价值。PTC 的纤维化程度与预后密切相关。PTC 病变的硬度和 CTGF 的表达水平与常规超声区分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。
