分化型甲状腺癌患者血清基质金属蛋白酶-13表达水平与肺转移的相关性研究

目的探讨分化型甲状腺癌(DTC)患者血清中基质金属蛋白酶-13(MMP-13)表达水平及其与肺转移的相关性。方法将70例未发生肺转移DTC患者纳入未转移组,46例发生肺转移DTC患者纳入转移组,35例健康体检者纳入对照组。检测并比较3组血清中MMP-13表达水平的变化;绘制受试者工作特征曲线(ROC),并分析血清MMP-13临床诊断效能。结果未转移组和转移组血清MMP-13表达水平均高于对照组,且转移组血清MMP-13表达水平高于未转移组,差异有统计学意义(P<0.01)。甲状腺包膜侵犯(OR=3.449)、颈淋巴结转移(OR=6.501)、纵隔淋巴结转移(OR=3.145)及MMP-13表达水平(OR=4.369)均是DTC患者发生肺转移的独立危险因素。ROC曲线结果显示,MMP-13表达水平诊断DTC患者发生肺转移的曲线下面积(AUC)为0.834(95%CI:0.743~0.924,P<0.05),当截断值为142.58 pg/mL,诊断敏感度和特异度分别为92.14%、86.39%。结论DTC患者血清中MMP-13表达水平显著升高,MMP-13可作为诊断其发生肺转移的血清学标志物。

Correlation between serum matrix metalloproteinase-13 expression levels and lung metastasis in patients with differentiated thvroid carcinoma

Objective To investigate the expression level of serum matrix metalloproteinase-13(MMP-13)in patients with differentiated thyroid carcinoma(DTC)and its correlation with lung metastasis.Methods A total of 70 DTC patients without lung metastasis were included in non-metastatic group,46 DTC patients with lung metastasis were included in metastatic group,and 35 healthy subjects were included in control group.The changes of expression levels of MMP-13 in serum of three groups were detected and compared.Receiver operating characteristic(ROC)curve was drawn and the clinical diagnostic efficacy of serum MMP-13 was analyzed.Results The expression levels of MMP-13 in the non-metastatic group and the metastatic group were significantly higher than those in the control group,and the expression level of MMP-13 in the metastatic group was significantly higher than that in the non-metastatic group(P<0.01).Thyroid capsule invasion(OR=3.449),cervical lymph node metastasis(OR=6.501),mediastinal lymph node metastasis(OR=3.145)and MMP-13 levels(OR=4.369)were all independent risk factors for lung metastasis in patients with DTC.ROC curve results showed that the area under the curve(AUC)of serum MMP-13 expression levels in the diagnosis of lung metastasis in patients with DTC was 0.834(95%CI,0.743 to 0.924,P<0.05).When the cut-off value was 142.58 pg/mL,the diagnostic sensitivity and specificity were 92.14%and 86.39%,respectively.Conclusion The expression levels of MMP-13 in the serum of DTC patients is significantly increased,and MMP-13 can be used as a serological marker for the diagnosis of lung metastasis.