甲状腺乳头状癌CT及MRI影像征象及其与雌激素受体、孕激素受体、C-myc表达的相关性研究  

CT and MRI Imaging Signs of Papillary Thyroid Carcinoma and Their Correlation with the Expression of Estrogen Receptor,Progesterone Receptor and C-myc

作　　者：吴梦婕 李丹 尹娜[1] 周治道 吴茜茜 WU Meng-jie;LI Dan;YIN Na;ZHOU Zhi-dao;WU Xi-xi(Image Center,Jiangsu Cancer Hospital,Nanjing,Jiangsu,210009,China;Department of Radiotherapy,Jiangsu Cancer Hospital,Nanjing,Jiangsu,210009,China)

机构地区：[1]江苏省肿瘤医院影像中心,江苏南京210009 [2]江苏省肿瘤医院放疗科,江苏南京210009

出　　处：《现代生物医学进展》2021年第21期4152-4157,共6页Progress in Modern Biomedicine

基　　金：江苏省卫生健康委科研项目(BJ19032)。

摘　　要：目的:探讨甲状腺乳头状癌(PTC)计算机断层扫描(CT)、磁共振成像(MRI)影像征象及其与雌激素受体(ER)、孕激素受体(PR)、C-myc表达的相关性。方法:回顾性分析2019年6月-2020年12月于我院74例诊断为PTC患者的计算机断层扫描CT、MRI影像资料,以手术病理结果作为金标准。分析患者的CT、MRI影像学特征。采用免疫组织化学染色分析ER、PR、C-myc的表达情况。采用Spearman秩相关分析评价CT、MRI影像学特征及其与ER、PR、C-myc表达水平的相关性。结果:PTC患者CT、MRI主要表现为混杂密度/信号,多数病灶形态不规则,病灶突破甲状腺被膜外缘呈咬饼征改变、侵犯周围组织及病灶内见细颗粒状钙化时提示恶性程度较高,患者早期出现颈部淋巴结转移较多。ER、PR、C-myc阳性表达者分别为51例(68.92%)、44例(59.46%)、64例(86.49%)。C-myc阳性表达与PTC肿瘤直径有关,组间差异有统计学意义(P<0.05);ER、PR、C-myc阳性表达与PTC形态、咬饼征及淋巴结转移有关,组间差异均有统计学意义(P<0.0);ER、C-myc阳性表达与PTC边界有关,组间差异有统计学意义(P<0.05);ER阳性表达与PTC增强后病灶范围缩小/模糊有关,组间差异有统计学意义(P<0.05);ER、PR、C-myc阳性表达与其余CT、MRI影像学表现特征无关,组间差异均无统计学意义(P>0.05)。咬饼征与PR、C-myc表达水平呈正相关(P<0.05),淋巴结转移状态与ER、PR、C-myc表达水平呈正相关(P<0.05),其余影像学表现特征与ER、PR、C-myc表达水平无明显相关性(P>0.05)。结论:CT、MRI影像征象可在一定程度上评估PTC患者肿瘤细胞的生物学行为,可间接反映肿瘤分化程度、浸润程度等情况,对指导临床综合治疗及评估患者预后可提供客观依据。Objective:To explore the correlation between computed tomography(CT)and magnetic resonance imaging(MRI)characteristics of papillary thyroid carcinoma(PTC)and expression of estrogen receptor(ER),Progesterone receptor(PR),and C-myc.Methods:The CT and MRI data of 74 patients with PTC diagnosed in our hospital from June 2019 to December 2020 were retrospectively analyzed,and the surgical pathological results were taken as the gold standard.The imaging features of CT and MRI were analyzed.Immunohistochemical staining was used to analyze the expression of ER,PR and C-myc.Spearman rank correlation analysis was used to evaluate the correlation between CT and MRI imaging features and the expression levels of ER,PR and C-myc.Results:CT and MRI in PTC patients were mainly characterized by mixed density/signal,and most lesions were irregular in shape.When the lesions broke through the outer edge of thyroid capsule,the lesions presented cake bite sign change,invaded surrounding tissues,and fine granular calcification in the lesions indicated a high degree of malignancy,and the patients had more cervical lymph node metastasis in the early stage.The positive expressions of ER,PR and C-myc were 51(68.92%),44(59.46%)and 64(86.49%),respectively.The positive expression of C-myc was related to the PTC tumor diameter,and the difference was statistically significant(P<0.05);The positive expressions of ER,PR and C-myc were correlated with PTC morphology,bite cake sign and lymph node metastasis,and the difference were all statistically significant(P<0.05);The positive expression of ER and C-myc was related to the PTC boundary,and the difference was statistically significant(P<0.05);The positive expression of ER was related to the reduction/blurring of focus after enhancement,and the difference was statistically significant(P<0.05);The positive expression of ER,PR and C-myc had no correlation with other CT and MRI features,and there was no significant difference between the two groups(P>0.05).There was a positive correlation between bite

关 键 词：甲状腺乳头状癌 影像征象 雌激素受体 孕激素受体 C-MYC 相关性 

分 类 号：R736.1[医药卫生—肿瘤]