术前血清降钙素检测在评估甲状腺髓样癌不同区域淋巴结转移中的临床价值

目的 探讨术前血清降钙素(calcitonin,Ctn)在评估甲状腺髓样癌(medullary thyroid carcinoma,MTC)不同区域淋巴结转移中的临床应用价值.方法 回顾性研究2009年1月～2020年1月在浙江省肿瘤医院头颈外科接受初次手术的128例MTC的病例资料,分析术前血清Ctn和不同区域淋巴结...

Clinical value of preoperative serum calcitonin to evaluate the lymph node metastasis in different regions of medullary thyroid carcinoma

OBJECTIVE To explore the clinical value of preoperative serum calcitonin(Ctn)in predicting lymph node metastasis of medullary thyroid carcinoma(MTC).METHODS 128 MTC patients from Zhejiang Cancer Hospital between Jan.2009 to Jan.2020 were enrolled in this study.The relationship of preoperative serum Ctn and lymphatic metastasis was retrospectively analyzed.Receiver operating characteristic curve(ROC)was made to evaluate the clinical efficacy of preoperative serum Ctn in predicting the metastasis of central lymph node,lateral lymph node and upper mediastinal lymph node.RESULTS The lymphatic metastasis rate of central lymph node,lateral lymph node and upper mediastinal lymph node in 128 MTC patients was 53.91%,45.31%and 14.84%,respectively.The positive expression rate of serum Ctn in 128 cases of MTC was 96.09%.The levels of serum Ctn in MTC with lymph node metastasis were significantly higher than those without lymph node metastasis(all P<0.05).The level of serum Ctn expression was positively correlated with the number of lymph node metastases in MTC patients(all P<0.001).The area under curve of predicting metastasis of central lymph node,lateral lymph node and upper mediastinal lymph node was 0.809,0.846 and 0.803,respectively.When the cut-off values of serum Ctn were 287.6 pg/ml,303.1 pg/ml and 747.75 pg/ml,the sensitivity of serum Ctn for predicting lymphatic metastasis of three sites was 85.50%,93.10%,94.40%,and the specificity was 71.20%,70.00%,62.70%,respectively.CONCLUSIONSerum Ctn has a very high positive expression rate in MTC patients,and its expression level has important clinical value in the evaluation of MTC lymph node metastasis.