甲状腺微小乳头状癌患者血清ProGRP、IGF-1、CYFRA21-1的水平变化

Changes of serum ProGRP, IGF-1 and CYFRA21-1 levels in patients with papillary thyroid microcarcinoma

摘要

目的 探究甲状腺微小乳头状癌（PTMC）患者血清胰岛素样生长因子-1（IGF-1）、细胞角蛋白19片段抗原21-1（CYFRA21-1）、胃泌素释放肽前体（ProGRP）的水平变化。方法 收集2024年3月—2024年11月于许昌市人民医院就诊的60例PTMC患者为研究组,另收集同期60例微小结节性甲状腺肿患者为对照组,比较2组血清ProGRP、IGF-1、CYFRA21-1水平,进一步分析不同临床分期（Ⅰ~Ⅱ期、Ⅲ~Ⅳ期）、预后患者血清ProGRP、IGF-1、CYFRA21-1水平,采用受试者工作特征（ROC）曲线分析联合预测价值。结果 研究组、Ⅲ~Ⅳ期患者入院时血清ProGRP、CYFRA21-1水平高于对照组、Ⅰ~Ⅱ期患者,IGF-1低于对照组、Ⅰ~Ⅱ期患者（P<0.05）;ProGRP、CYFRA21-1水平均与临床分期呈正相关,IGF-1与之呈负相关（P<0.05）;预后良好患者治疗1个月、3个月时,血清ProGRP、CYFRA21-1水平低于预后不良患者,IGF-1高于预后不良患者（P<0.05）;治疗1个月、3个月时,血清ProGRP、IGF-1、CYFRA21-1水平联合预测预后不良的AUC分别为0.858、0.901。结论 PTMC患者血清ProGRP、IGF-1、CYFRA21-1呈异常表达,并可预测PTMC预后不良发生风险,对改善患者临床预后具有积极意义。

Abstract

Objective To investigate the changes of serum insulin-like growth factor-1 (IGF-1), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and pro-gastrin-releasing peptide (ProGRP) levels in patients with papillary thyroid microcarcinoma (PTMC). Methods A total of 60 patients with PTMC who were treated in Xuchang People's Hospital from March 2024 to November 2024 were collected as the study group. In addition, 60 patients with micronodular goiter were collected as the control group. Compare the serum levels of ProGRP, IGF-1 and CYFRA21-1 between the two groups, further analyze the above indexes in patients with different clinical stages (stage Ⅰ-Ⅱ, stage Ⅲ-Ⅳ) and different prognoses, and adopt receiver operating characteristic (ROC) curve to analyze the combined predictive value. Results The serum levels of ProGRP and CYFRA21-1 on admission in the study group and stage Ⅲ-Ⅳ patients were higher than those in the control group and stage Ⅰ-Ⅱ patients, while IGF-1 levels were lower (P<0.05); the levels of ProGRP and CYFRA21-1 were positively correlated with clinical stage, and IGF-1 was negatively correlated with it (P<0.05). At 1 and 3 months after treatment, patients with good prognosis presented lower serum ProGRP and CYFRA21-1 levels and higher IGF-1 levels compared with those with poor prognosis (P<0.05). The AUC of ProGRP, IGF-1 and CYFRA21-1 levels combined to predict poor prognosis at 1 month and 3 months of treatment were 0.858 and 0.901, respectively. Conclusion The abnormal expression of serum ProGRP, IGF-1 and CYFRA21-1 in PTMC patients can predict the risk of poor prognosis of PTMC, which is of positive significance for improving the clinical prognosis of patients.

关键词

甲状腺微小乳头状癌 / 胰岛素样生长因子-1 / 细胞白蛋白19片段抗原21-1 / 胃泌素释放肽前体

Key words

papillary thyroid microcarcinoma / insulin-like growth factor-1 / cytokeratin 19 fragment antigen 21-1 / pro-gastrin-releasing peptide

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