CDFI联合VEGF测定鉴别甲状腺肿瘤良恶性的可行性研究  

A feasibility study of CDFI combined with VEGF on identification of benign and malignant thyriod tumor

作　　者：严旦红 张炽敏[1] 胡中倩[1] 缪卫娟 

机构地区：[1]东南大学医学院,江苏南京210009 [2]江阴市妇幼保健所,江苏江阴214400

出　　处：《东南大学学报（医学版）》2015年第2期217-221,共5页Journal of Southeast University(Medical Science Edition)

基　　金：中央高校基本科研业务费专项资金资助项目(No.2242014K40004)

摘　　要：目的:分析甲状腺肿瘤彩色多普勒血流显像(CDFI)与血管内皮生长因子(VEGF)测定的相关性,探讨术前应用CDFI联合VEGF检测鉴别甲状腺肿瘤良、恶性的可行性。方法:外科手术治疗的甲状腺肿瘤患者80例,术前用CDFI显示结节内部及周边血流信号,对血流丰富程度进行分级。术后病理标本用免疫组织化学法检测VEGF。对病理诊断为良性和恶性的两组病例分别做CDFI血流分级与VEGF表达的相关性分析,并用CDFI联合VEGF检测的方法,对甲状腺肿瘤的良、恶性进行模拟预测。结果:80例中共有96个甲状腺肿瘤结节,其中57个恶性结节,39个良性结节。良性组的CDFI血流分级明显低于恶性组(P<0.001);良性组的VEGF多呈"+^++"表达,恶性组VEGF多呈"++^+++"表达。VEGF与CDFI具有相关性(P<0.01)。CDFI结合VEGF分级对恶性肿瘤的阳性预测值为98.25%,高于仅凭CDFI诊断甲状腺恶性肿瘤的75.44%。结论:甲状腺肿瘤内部血供丰富程度与VEGF表达具有相关性,恶性组内部的血流丰富程度显著高于良性组,CDFI结合VEGF测定可以明显提高对甲状腺良、恶性病变鉴别的符合率。甲状腺肿瘤的CDFI检查结合VEGF测定,有可能成为术前对甲状腺肿瘤良恶性进行鉴别的一种新的方法。Objective： To analyse the correlation of color doppler flow imaging（ CDFI） and vascular endothelial growth factor（ VEGF） in testing thyroid tumors,and discuss the application of preoperative joint of CDFI and VEGF in order to test the feasibility of the identification of benign and malignant thyroid tumor. Methods： Preoperative application of CDFI to 80 patients with thyroid tumors showed flowing signals inside and outside the nodules and their blood flow was graded according to the amount. Postoperative pathological specimens were tested on VEGF with immune histochemical method. The specimens were tested respectively on the correlation of CDFI blood flowing grading and VEGF expression. What＇s more,we predicted whether the thyroid tumors were benign or malignant through simulation. Results： Out of the 80 cases,there were 96 thyroid tumor nodules,of which 57 were malignant,39 benign. The CDFI blood flowing grading of benign group was obviously lower than that of malignant group（ P〈0. 001）; The VEGF of benign group gave the expression ＂ ＋ ~ ＋ ＋ ＂,malignant group＇s VEGF expression was ＂ ＋ ＋ ~ ＋ ＋ ＋ ＂. The study showed VEGF and CDFI were correlative（ P〈0. 01）. CDFI combined with VEGF grading of malignancy of positive predictive value was 98. 25%,which higher than a mere 75. 44% of only CDFI in the diagnosis of thyroid malignant tumor. Conclusion： The amount of thyroid tumor＇s blood supply is correlative with VEGF expression,and in the malignant group internal blood flowing is significantly higher than that in benign group. Therefore,along with VEGF,color doppler flow imaging can obviously help identify benign and malignant thyroid lesions. Hopefully,this method is likely to be a new preoperative identification of benign and malignant thyroid tumor.

关 键 词：甲状腺肿瘤 彩色多普勒超声成像 血管内皮生长因子 

分 类 号：R736.1[医药卫生—肿瘤] R730.41[医药卫生—临床医学]