| In recent years,with the continuous improvement of social economy,the improvement of people’s awareness of physical examination and the rapid development of medical technology,the detection rate of thyroid nodules is significantly higher than before,and now it has become one of the common diseases in endocrinology and thyroid surgery.A small number of patients with thyroid nodules were diagnosed as thyroid cancer at the time of discovery or subsequently.Thyroid cancer progressed relatively slowly,and most of the patients had a good prognosis.However,there are still some patients with adverse outcomes due to local invasion or even distant metastasis of the tumor.Therefore,it is particularly important to find and identify the benign and malignant thyroid nodules in the early stage.Ultrasound-guided fine needle aspiration has become one of the important methods for preoperative diagnosis of thyroid cancer,but sometimes cytology and pathology can not make a clear diagnosis because of the differences in the level of doctors.In order to further clarify the nature of patients’nodules,often need to be combined with molecular detection.Serum insulin-like growth factor-1(IGF-1)is mainly known for its role in promoting growth,but also involved in the control of intermediate metabolism,tissue repair and the occurrence of some diseases.Previous studies have shown that it is related to the occurrence and development of thyroid nodules.In this study,according to the pathological classification of fine needle aspiration of thyroid nodules,the serum IGF-1levels of patients in different groups were compared with those of healthy controls,in order to understand the relationship between the level of IGF-1and the pathological classification of fine needle aspiration of thyroid nodules,so as to provide reliable experimental data and theoretical basis for clinical work.Objective:To analyze the correlation between serum IGF-1 level and pathological classification of different thyroid nodules by fine needle aspiration,so as to provide theoretical basis for further clarifying the nature of thyroid nodules.Methods:Forty-four patients(>18 years old)with thyroid nodules diagnosed as thyroid nodule puncture indication in the Department of Endocrinology and Metabolism of Cangzhou people’s Hospital from October 2021 to December 2022 were selected.Among them,the patients with pathological classificationⅡ～Ⅲ were nodules group A(there were no patients with pathological classificationⅠand had not been repeatedly punctured in this study),a total of24 patients,and the patients with pathological classification Ⅳ～Ⅵ were nodule group B.There were 20 cases.Forty-four healthy subjects admitted to the physical examination center of Cangzhou People’s Hospital during the same period were selected as the control group.There were no significant differences in age,sex,height,weight,or body mass index(Body mass index,BMI)between the control group and the thyroid nodules group.According to the collected data of the healthy control group and the thyroid nodule group,the healthy control group was divided into control group A and control group B.Age,sex,height,weight,BMI,fasting blood glucose(FPG),Alanine transaminase(ALT),Aspartate transaminase(AST),creatinine(CR),thyroglobulin(TG)and thyroid stimulating hormone(TSH),free triiodothyronine(FT3),free thyroxine(FT4),anti-thyroglobulin antibody(Anti-Tg),anti-thyroid peroxidase antibody(Anti-TPO)were collected from patients with thyroid nodules.The age,sex,height,weight,BMI,FPG,ALT,AST and CR of the healthy control group were collected.The serum IGF-1level was measured by the same kit and method,venous blood 2 ml by 8 hours after fasting in the healthy control group and the thyroid nodule group was collected and stored in the refrigerator at-80℃.Differences ingeneral data and some biochemical indices between these groups were compared,and differences in serum IGF-1 between the different groupswere compared by T-test or analysis of variance.The correlation betweenthe indices was analyzed using Pearson correlation analysis,the recipient’s Operational Characteristic(ROC)curve was drawn,and the area underthe curve(AUC)was determined to analyze the sensitivity and specificity of serum IGF-1 in the assessment of benign and malignant thyroid nodules.Results:1.44 patients with thyroid nodules with indications of thyroid puncture were included in the case group,including 13 men and 31 women,aged 19 to72 years,with a mean(50.98±12.05)years.There were 44 cases in the healthy control group and the number of men and women was the same as that of thyroid nodules.The age range is 20-72 years,with an average age(50.89±11.95)years.There were no significant differences in sex,age,height,weight,BMI and IGF-1,FPG,ALT,AST,Cr serum between the two groups.2.There were 24 patients in nodule group A,including 5 males and 19 females,with an average age(53.92±12.24)years,and the control A group was 24 healthy physical examiners,the number of men and women was the same as that of nodule group,and the average age(53.71±12.22)years old,comparing the general data and biochemical data of the two groups,it can be seen that the FPG of nodule A group were higher than those in control A,and IGF-1,ALT,AST and Cr were lower than those in the control group,but the difference was not statistically significant(P>0.05).3.There were 20 patients in nodule group B,including 8 males and 12females,with an average age of(47.45±11.10)years.The number,sex,age,height,weight and BMI of control group B were matched with those of nodule group,in which the average age was(47.50±10.96)years old and the weight was(63.35±8.52)kg.The height was non-normal distribution,which was expressed as 163.00(162.00,168.75)cm by median(quartile interval).The serum IGF-1 level in control group B was(137.34±29.14)ng/ml,and the serum IGF-1 level in nodule group B was(160.12±38.24)ng/ml,which was significantly higher than that in control group B.there was no significant difference in FPG,ALT,AST and Cr between the two groups.4.The general data and biochemical indexes of nodule group An and nodule group B were compared and analyzed.Chi-square test should be used to compare the counting data.The result wasc~2=1.925,P=0.165,so there was no significant difference between the two groups(P>0.05).Comparing the general data of the two groups,there was no significant difference in age,height,weight and BMI between nodule group An and nodule group B.There was no significant difference in FT3,FT4,TSH,Anti-TPO,Anti-Tg,Tg,FPG,ALT,AST and Cr between nodule group An and group B,but there was significant difference in serum IGF-1 level between the two groups.5.Pearson correlation analysis was used to compare the correlation between serum IGF-1 level and various indexes.Linear correlation analysis showed that serum IGF-1 had no linear relationship with sex,height,weight,FPG,FT3,FT4,Anti-TPO and Tg,but negatively correlated with age and BMI,but positively correlated with TSH and Anti-Tg.6.The AUC of the ROC curve of serum IGF-1 in patients with thyroid nodules was 0.681(95%confidence interval was 0.521-0.842).The Yoden index was calculated.The best critical value of serum IGF-1 was 137.435ng/ml,the sensitivity was 80.0%and the specificity was 54.2%.Conclusions:1.The level of serum IGF-1 in patients with pathological classification Ⅳ～Ⅵ was significantly higher than that in patients with pathological classification Ⅱ～Ⅲ and healthy crowd。2.The level of serum IGF-1 was negatively correlated with age and BMI,and positively correlated with TSH and Anti-Tg. |
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