超声造影参数在甲状腺癌诊断中的应用价值及与病灶组织中癌细胞恶性生物学特征的相关性  

Value of Contrast-enhanced Ultrasound Parameters in the Diagnosis of Thyroid Cancer and the Correlation with Malignant Biological Characteristics of Cancer Cells in the Lesion Tissue

作　　者：葛建丽[1] 刘敏洁[1] 徐更田[1] 赵晓[1] 何好超 GE Jianli;LIU Minjie;XU Gengtian(Puyang Oilfield General Hospital,Puyang,457001)

机构地区：[1]河南省濮阳市油田总医院,457001

出　　处：《实用癌症杂志》2021年第2期265-270,共6页The Practical Journal of Cancer

摘　　要：目的探究超声造影参数在甲状腺癌诊断中的应用价值及与病灶组织中癌细胞恶性生物学特征的相关性。方法选取117例接受超声造影检查的甲状腺结节患者,根据细针穿刺活检结果判断结节良恶性,其中良性76例作为对照组,恶性41例作为研究组。对比2组超声造影参数[曲线下面积(AUC)、达峰时间(TTP)、平均通过时间(MTT)、峰值强度(Peak)]、病灶组织中血管新生基因表达量[血管内皮生长因子(VEGF)、中枢性粘液表皮样瘤(c-met)、缺氧诱导因子α(HIF-α)]、侵袭基因表达量[趋化因子受体4(CXCR4)、特异结合蛋白1(SATB1)、金属蛋白酶解离素9(ADAM9)]、增殖基因表达量[蛋白磷酸酶4调节亚基1(PP4R1)、靶向Xklp2靶蛋白(TPX2)、线粒体促凋亡蛋白(Smac)]及自噬基因表达量[Beclin1蛋白(Beclin1)、磷酸酶张力蛋白样同源物(PTEN)、小ras同源蛋白Ⅰ(ARHⅠ)],探究超声造影参数对甲状腺癌的诊断价值,及与病灶组织中血管新生、增殖、侵袭及自噬基因表达的相关性。结果研究组AUC、TTP、Peak、MTT均低于对照组(P<0.05);超声造影参数联合诊断甲状腺癌的AUC为0.894,大于超声造影各参数单一诊断,联合诊断的最佳敏感度为80.49%,特异度为85.53%。研究组VEGF、c-met、HIF-α基因表达量均高于对照组(P<0.05);研究组PP4R1、Smac基因表达量低于对照组,TPX2基因表达量高于对照组(P<0.05);研究组CXCR4、SATB1、ADAM9基因表达量高于对照组(P<0.05);研究组Beclin1、PTEN、ARHⅠ基因表达量低于对照组(P<0.05)。甲状腺癌患者超声造影参数AUC、TTP、Peak、MTT与病灶组织中VEGF、c-met、HIF-α、TPX2、CXCR4、SATB1、ADAM9基因表达量存在负相关关系,与PP4R1、Smac、Beclin1、PTEN、ARHⅠ基因表达量存在正相关关系(P<0.05)。结论超声造影对甲状腺癌具有较高的诊断价值,且其参数与病灶组织中血管新生基因、侵袭基因、增殖基因及自噬基因表达量存在密切相关Objective To explore the application value of contrast-enhanced ultrasound parameters in the diagnosis of thyroid cancer and the correlation with the malignant biological characteristics of cancer cells in the lesion tissue.Methods 117 patients with thyroid nodules who underwent contrast-enhanced ultrasound examination were selected.According to the results of fine needle aspiration biopsy,the benign and malignant nodules were judged,and 76 cases of benign were used as the control group and 41 cases of malignant were used as the study group.The contrast-enhanced ultrasound parameters[area under the curve(AUC),time to peak(TTP),mean transit time(MTT),peak intensity(Peak)],the expression levels of angiogenesis genes[vascular endothelial growth factor(VEGF),central mucoepidermoid tumor(c-met),hypoxia-inducible factorα(HIF-α)],invasion genes in lesion tissues[chemokine receptor 4(CXCR4),specific binding protein 1(SATB1),metalloproteinase dissociin 9(ADAM9)],and proliferative gene expression in lesion tissue[protein phosphatase 4 regulatory subunit 1(PP4R1),target Xklp2 target protein(TPX2),mitochondrial proapoptotic protein(Smac)]and autophagy genes in the lesion tissue[Beclin1 protein(Beclin1),phosphatase tensin-like homolog(PTEN),small ras homologⅠ(ARHⅠ)]in the 2 groups were compared.Results The AUC,TTP,Peak,and MTT of the study group were lower than those of the control group(P<0.05).The AUC for the combined diagnosis of thyroid cancer with contrast-enhanced ultrasound parameters was 0.894,which was greater than the single diagnosis of contrast-enhanced ultrasound parameters,the optimal sensitivity for combined diagnosis was 80.49%and the specificity was 85.53%.The expression levels of VEGF,c-met and HIF-αgenes in the study group were higher than those in the control group(P<0.05).The expression level of PP4R1 and Smac genes in the study group was lower than that in the control group,and the expression level of TPX2 gene was higher than in the control group(P<0.05).The expression levels of CXCR4,SATB1 and A

关 键 词：甲状腺癌 超声造影 诊断 血管新生基因 侵袭基因 自噬基因 

分 类 号：R736.1[医药卫生—肿瘤]