摘要
目的探讨甲状腺良恶性实性结节CEUS增强模式与CD34、VEGF、CK19和Ki-67免疫组织化学表达的相关性。方法采用低机械指数实时灰阶谐波CEUS技术,对80例甲状腺患者的82个实性结节进行CEUS,包括甲状腺乳头状癌结节38个、髓样癌3个,结节性甲状腺肿31个、腺瘤7个、桥本病结节3个。术后行CD34、VEGF、CK19和Ki-67免疫组织化学染色。比较良恶性结节CEUS增强模式和免疫组织化学表达水平差异,分析其相关性。结果甲状腺良恶性结节的增强模式存在差别(P<0.01),良性结节78.05%(32/41)表现为环状增强,恶性结节92.68%(38/41)表现为不均匀增强。恶性结节的CD34、VEGF、CK19和Ki-67表达显著高于良性结节(P<0.01)。非均匀增强与CD34、VEGF、CK19呈正相关(r=0.39,P<0.001;r=0.26,P=0.04;r=0.54,P<0.001);环状增强与CD34、CK19、Ki-67呈负相关(r=-0.38,P<0.001;r=-0.59,P<0.001;r=-0.25,P=0.03)。结论 CEUS和CD34、VEGF、CK19和Ki-67免疫组织化学染色有助于鉴别甲状腺良恶性结节。
Objective To explore the relationship between enhance patterns of solid thyroid nodules in CEUS and their immunohistochemical expressions of CD34,VEGF,CK19 and Ki-67.Methods Eighty-two solid thyroid nodules in 80 patients（38 papillary carcinomas,3 medullary carcinomas,31 goiters,7 adenomas,3 nodules of Hashimoto disease） were examined with CEUS prospectively.After surgery,paraffin samples were stained with CD34,VEGF,CK19,and Ki-67 immunohistochemically.The enhance patterns and immunohistochemical expression of benign and malignant thyroid nodules were compared,and the correlation of the two methods was analyzed.Results There were significant differences between the benign and malignant nodules（P0.01）.There was 78.05%（32/41） benign nodules showed ring enhancement,92.68%（38/41） malignant nodules showed inhomogeneous enhancement.The expressions of the CD34,VEGF,CK19 and Ki-67 were significantly higher in malignant nodules than in benign ones（P0.01）.Inhomogeneous enhancement positively correlated with CD34,VEGF and CK19（r=0.39,P0.001;r=0.26,P=0.04;r=0.54,P0.001）.Ring enhancement negatively correlated with CD34,CK19 and Ki-67（r=-0.38,P0.001;r=-0.59,P0.001;r=-0.25,P=0.03）.Conclusion CEUS and immunohistochemistry are both useful tools to differentiate benign and malignant thyroid nodules.
出处
《中国医学影像技术》
CSCD
北大核心
2011年第9期1783-1787,共5页
Chinese Journal of Medical Imaging Technology
基金
首都临床特色应用研究基金(2011)
关键词
甲状腺结节
超声检查
介入性
新生血管化
病理性
免疫组织化学
Thyroid nodule
Ultrasonography
interventional
Neovascularization
pathologic
Immunohistochemistry
