| 沈 娟,丁怀银,杜 超,袁 军,李怀花.能谱CT成像对甲状腺癌局部浸润深度的诊断价值及其定量参数与肿瘤组织中Ki67、VEGF、CD34、EGFR的相关性[J].,2023,(3):483-488 |
| 能谱CT成像对甲状腺癌局部浸润深度的诊断价值及其定量参数与肿瘤组织中Ki67、VEGF、CD34、EGFR的相关性 |
| Diagnostic Value of Energy Spectrum CT Imaging in the Depth of Local Infiltration of Thyroid Cancer and the Correlation of its Quantitative Parameters with Ki67, VEGF, CD34 and EGFR in Tumor Tissue |
| 投稿时间：2022-06-04 修订日期：2022-06-27 |
| DOI：10.13241/j.cnki.pmb.2023.03.017 |
| 中文关键词: 能谱CT成像 甲状腺癌 浸润深度 Ki67 VEGF CD34 EGFR 相关性 诊断价值 |
| 英文关键词: Energy spectrum CT imaging Thyroid cancer Depth of infiltration Ki67 VEGF CD34 EGFR Correlation Diagnostic Value |
| 基金项目:江苏省卫计委面上科研课题基金项目（H201648） |
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| 中文摘要: |
| 摘要 目的：探讨能谱CT成像对甲状腺癌局部浸润深度的诊断价值及其定量参数与肿瘤组织中Ki67、VEGF、CD34、EGFR的相关性。方法：回顾性分析2018年6月-2021年6月我院经手术或穿刺活检病理证实为甲状腺肿瘤性病变的患者96例，其中29例为甲状腺癌局部浸润组（A组），34例为甲状腺癌无浸润组（B组），33例为甲状腺腺瘤组（C组）。另取56例甲状腺另一侧叶正常组织作为对照组（D组）。所有患者均完善能谱CT检查，采集图像后在能谱CT Viewer分析软件上测量病变区碘浓度，计算能谱曲线斜率。采用免疫组织化学染色分析Ki-67、VEGF、CD34、EGFR的表达情况。采用Spearman秩相关分析评价碘浓度、能谱曲线斜率与甲状腺癌肿瘤组织中Ki-67、VEGF、CD34、EGFR表达的相关性。结果：在平扫、动脉期、静脉期，A组、B组、C组和D组的碘浓度逐渐增大，两两比较差异均有统计学意义（P＜0.05）。甲状腺癌局部浸润组织能谱曲线呈"低平型"，斜率为较小负值，正常甲状腺组织能谱曲线为下降型，斜率为负值；在平扫、动脉期、静脉期，A组、B组、C组和D组的能谱曲线斜率逐渐变小，差异均有统计学意义（P＜0.05）。A组中Ki-67、VEGF、CD34和EGFR的阳性表达率均高于B组和C组，差异均有统计学意义（P＜0.05）。碘浓度在动脉期、静脉期与Ki-67、VEGF、CD34、EGFR表达呈正相关（P＜0.05），碘浓度在平扫与Ki-67表达呈正相关（P＜0.05），碘浓度在平扫与VEGF、CD34、EGFR表达无相关性（P＞0.05）。能谱曲线斜率在动脉期、静脉期与Ki-67、VEGF、CD34、EGFR表达呈正相关（P＜0.05），能谱曲线斜率在平扫与VEGF表达呈正相关（P＜0.05），能谱曲线斜率在平扫与Ki-67、CD34、EGFR表达无相关性（P＞0.05）。结论：能谱CT成像检查对甲状腺癌局部浸润深度的判断具有重要的价值，其定量参数碘浓度、能谱曲线斜率与Ki67、VEGF、CD34、EGFR具有相关性，可间接反映肿瘤微血管、肿瘤血管生成、甲状腺癌分化程度、浸润程度等情况，对评价甲状腺癌生物学行为可提供有价值的信息。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the diagnostic value of energy spectrum CT imaging in the depth of local infiltration of thyroid cancer and the correlation of its quantitative parameters with Ki67, VEGF, CD34 and EGFR in tumor tissue. Methods: A retrospective analysis was performed on 96 patients with thyroid neoplastic lesions confirmed by surgery or biopsy pathology in our hospital from June 2018 to June 2021, including 29 patients with local infiltration of thyroid cancer (group A), 34 patients with no infiltration of thyroid cancer (group B), and 33 patients with thyroid adenoma (group C). Another 56 normal tissues of the other lobe of thyroid were taken as control group (group D). All patients underwent complete energy spectral CT examination, and after acquisition of images, iodine concentration in the lesion area was measured on the energy spectral CT viewer analysis software to calculate the slope of the energy spectral curve. Immunohistochemical staining was used to analyze the expressions of KI-67, VEGF, CD34 and EGFR.Spearman rank correlation analysis was used to evaluate the correlation between iodine concentration, the slope of energy spectrum curve and the expression of Ki-67, VEGF, CD34 and EGFR in thyroid cancer tissues. Results: In the plain scan, arterial phase and venous phase, the iodine concentration in group A, group B, group C and group D increased gradually, and the difference were statistically significant (P<0.05). The energy spectrum curve of local infiltrating of thyroid cancer was " low flat type ", with a slope of a small negative value, the normal thyroid tissue energy spectrum curve was a decreasing type, with a slope of a negative value; In the plain scan, arterial phase and venous phase, the slopes of the energy spectral curves of groups A, B, C, and D became progressively smaller, and the differences were statistically significant(P<0.05). The positive expression rates of KI-67, VEGF, CD34 and EGFR in group A were higher than those in non-infiltrated thyroid cancer and thyroid adenoma, and the differences were statistically significant(P<0.05). Iodine concentration was positively correlated with the expressions of KI-67, VEGF, CD34 and EGFR in arterial and venous phase(P<0.05), iodine concentration was positively correlated with the expressions of KI-67 in plain scan(P<0.05), iodine concentration was not correlated with the expressions of VEGF, CD34 and EGFR in plain scan (P>0.05). The slope of ENERGY spectrum curve was positively correlated with the expressions of KI-67, VEGF, CD34 and EGFR in arterial phase and venous phase(P<0.05), the slope of energy spectrum curve was positively correlated with the expressions of VEGF in plain scan(P<0.05), the slope of energy spectrum curve was not correlated with the expressions of KI-67, CD34 and EGFR in plain scan (P>0.05). Conclusion: Energy spectrum CT imaging has important value in judging the depth of local infiltration of thyroid cancer, Its quantitative parameters iodine concentration and energy spectrum curve slope are correlated with Ki67, VEGF, CD34 and EGFR, Which can indirectly reflect the tumor microvessels, tumor angiogenesis, the degree of differentiation and infiltration of thyroid cancer, and provide valuable information for evaluating the biological behavior of thyroid cancer. |
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