手术前后分化型甲状腺癌患者超声造影定量参数、血清缺氧诱导因子-2α水平的变化及临床价值OA

Objective:To investigate the changes in quantitative parameters of contrast-enhanced ultrasound and serum hypoxia-inducible factor-2α(HIF-2α)levels in patients with differentiated thyroid cancer(DTC)before and after surgery,and analyze their correlations with clinical pathological characteristics and their prognostic predictive value.Methods:A retrospective analysis method was adopted,106 DTC patients admitted to Xinyang People's Hospital from Jan 2022 to Jan 2024 were selected as the subjects and included in the study group,and 53 patients with benign thyroid nodules during the same period were selected as the control group.The quantitative parameters of contrast-enhanced ultrasound[peak intensity(PI),time to peak(TTP),and maximum perfusion intensity(SImax)]and serum HIF-2α levels were compared between the two groups.The quantitative parameters of contrast-enhanced ultrasound and serum levels of HIF-2α in DTC patients with different clinical pathological characteristics were analyzed,and their correlation with clinical pathological characteristics was analyzed.The study group underwent surgical treatment.Based on the prognosis within 1 year after the surgery,the patients were divided into the poor prognosis subgroup and the good prognosis subgroup.The quantitative parameters of contrast-enhanced ultrasound and serum HIF-2α levels were compared between the two subgroups.The correlation between quantitative parameters of contrast-enhanced ultrasound,serum HIF-2α levels,and prognosis was analyzed using partial correlation analysis.The prognostic predictive value of quantitative parameters of contrast-enhanced ultrasound and serum HIF-2α levels was analyzed.Results:At the time of admission,the PI,TTP and Simax in the study group were significantly lower than those in the control group,while the serum HIF-2α level was higher than that in the control group(P＜0.05).PI,TTP and SImax were negatively correlated with clinical stage(r=-0.528,-0.603,-0.492,P＜0.05)and lymph node metastasis(r=-0.574,-0.502,-0.617,P<0.05),but positively correlated with differentiation degree(r=0.623,0.592,0.477,P＜0.05).HIF-2α was positively correlated with clinical stage and lymph node metastasis of DTC patients(r=0.612,0.483,P＜0.05),but negatively correlated with differentiation degree(r=-0.522,P＜0.05).At 1 week after operation,the PI,TTP and SImax of the poor prognosis subgroup were lower than those of the good prognosis subgroup,while the serum HIF-2α level was higher than that of the good prognosis subgroup(P＜0.05).Partial correlation analysis showed that,at 1 week after operation,PI,TTP and SImax were negatively correlated with prognosis,while serum HIF-2α level was positively correlated with prognosis(P＜0.01).At 1 week after operation,the AUC value of PI,TTP,SImax combined with serum HIF-2α level in predicting poor prognosis of DTC patients at 1 year after operation was significantly higher than that of individual indicators.Conclusions:The PI,TTP and SImax of DTC patients are decreased,and the serum HIF-2α level is increased,which is closely related to clinical pathological characteristics and prognosis.The detection of these parameters has certain predictive value for prognosis,and combined detection can improve the predictive efficacy.