甲状腺恶性结节CT纹理分析参数与结节内癌基因表达的相关性研究  

Correlation between CT texture analysis parameters and expression of oncogene in nodular thyroid nodules

作　　者：王敬忠[1] 李锋[1] 朱襄明[1] 赵康艳[1] 陈韵 王晓霖[2] 李军[1] WANG Jingzhong;LI Feng;ZHU Xiangming;ZHAO Kangyan;CHEN Yun;WANG Xiaolin;LI Jun(Department of Radiology, Xiangyang Cetral Hospial Hubei Liberal Arts College Affiliated Hospital, Xiangyang 441021, P.R.China;Second Digestive Department, Xiangyang Cetral Hospial Hubei Liberal Arts College Affiliated Hospital, Xiangyang 441021, P.R.China)

机构地区：[1]湖北省襄阳市中心医院湖北文理学院附属医院放射影像科,湖北襄阳441021 [2]湖北省襄阳市中心医院湖北文理学院附属医院消化二科,湖北襄阳441021

出　　处：《医学影像学杂志》2019年第8期1292-1296,共5页Journal of Medical Imaging

基　　金：湖北省自然科学基金项目(编号:2013CFB385)

摘　　要：目的 检测甲状腺恶性结节CT纹理分析参数,探讨其与结节内癌基因表达的相关关系。方法 选择2014年12月~2018年2月间在本院进行甲状腺结节切除术治疗的甲状腺结节患者311例(409个病灶),收集其切除的结节病灶标本,并根据病理检查结果分为恶性组287个,良性组122个。检测甲状腺结节CT纹理,分析参数水平及结节内原癌基因、抑癌基因表达量。结果 恶性组CT纹理分析参数中熵值(6.94±0.78),高于良性组(5.88±0.65)(t=13.187,P=0.000)。两组偏度、峰态水平差异无统计学意义(t=-1.113、-1.062,P=0.133、0.144)。恶性组甲状腺结节中原癌基因RET、RAS、TRK、PAX8-PPARγ1mRNA的表达量均高于良性组甲状腺结节;抑癌基因DMBT1、DPC4、PTEN、TIP30mRNA的表达量均低于良性组甲状腺结节(t=15.563、19.834、12.422、23.745、-13.367、-6.386、-9.674、-20.182,P均<0.05)。甲状腺恶性结节的CT熵值与其中原癌基因表达量呈正相关,与抑癌基因表达量呈负相关(γ=0.310、0.298、0.463、0.571、-0.287、-0.354、-0.274、-0.417,P均<0.05)。结论 CT纹理分析参数中的熵值可用于甲状腺良恶性结节鉴别,且其具体水平与恶性结节中癌基因表达量直接相关,在判断结节恶性程度方面具有一定意义。Objective To investigate the correlation between CT texture analysis parameters and expression of oncogene in nodular thyroid nodules. Methods 311 cases (409 lesions) of thyroid nodules underwent thyroid nodule resection in our hospital from December 2014 to February 2018 were chosen as research subject, specimens were collected and divided into Malignant groups (n=287) and Benign groups (n=122) according to the pathological examination results. The CT texture analysis parameters of thyroid nodules and expression of proto-oncogenew, anti-oncogene in nodules were measured. Results Entropy value of CT texture analysis parameters in Malignant group (6.94±0.78) was higher than that in Benign group (5.88±0.65)( t =13.187). There were no significant differences in skewness and kurtosis level between two groups ( t =-1.113,-1.062, P =0.133, 0.144). Expression of proto-oncogene such as RET, RAS, TRK, PAX8-PPARγ1 mRNA in Malignant groups was higher than those in Benign groups, and expression of anti-oncogene such as DMBT1, DPC4, PTEN and TIP30 mRNA in Malignant groups was lower than those in Benign groups ( t =15.563, 19.834, 12.422, 23.745,-13.367,-6.386,-9.674,-20.182, P <0.05). Entropy value of malignant nodules was positively correlated with expression of proto-oncogenes, and was negatively correlated with expression of anti-oncogene (γ=0.310, 0.298, 0.463, 0.571, 0.287,-0.354,-0.274,-0.417, P <0.05). Conclusion Entropy value of CT texture analysis parameters can be used to identify benign and malignant nodules in thyroid, and its specific level is directly related to the expression of oncogene in malignant nodules, which has certain significance in degree of malignancy of nodule determination.

关 键 词：甲状腺癌 纹理分析参数 原癌基因 抑癌基因 体层摄影术 X线计算机 

分 类 号：R736.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]