东南大学学报（医学版）
東南大學學報（醫學版）
동남대학학보（의학판）
JOURNAL OF SOUTHEAST UNIVERSITY(MEDICAL SCIENCE EDITION)
2015年
2期
217-221
,共5页
严旦红%张炽敏%胡中倩%缪卫娟
嚴旦紅%張熾敏%鬍中倩%繆衛娟
엄단홍%장치민%호중천%무위연
甲状腺肿瘤%彩色多普勒超声成像%血管内皮生长因子
甲狀腺腫瘤%綵色多普勒超聲成像%血管內皮生長因子
갑상선종류%채색다보륵초성성상%혈관내피생장인자
thyroid tumor%color doppler flow imaging%vascular endothelial growth factor
目的：分析甲状腺肿瘤彩色多普勒血流显像（ CDFI）与血管内皮生长因子（ VEGF）测定的相关性，探讨术前应用CDFI联合VEGF检测鉴别甲状腺肿瘤良、恶性的可行性。方法：外科手术治疗的甲状腺肿瘤患者80例，术前用CDFI显示结节内部及周边血流信号，对血流丰富程度进行分级。术后病理标本用免疫组织化学法检测VEGF。对病理诊断为良性和恶性的两组病例分别做CDFI血流分级与VEGF表达的相关性分析，并用CDFI联合VEGF检测的方法，对甲状腺肿瘤的良、恶性进行模拟预测。结果：80例中共有96个甲状腺肿瘤结节，其中57个恶性结节，39个良性结节。良性组的CDFI血流分级明显低于恶性组（ P ＜0.001）；良性组的VEGF多呈“＋～＋＋”表达，恶性组VEGF多呈“＋＋～＋＋＋”表达。 VEGF与CDFI具有相关性（P＜0.01）。 CDFI结合VEGF分级对恶性肿瘤的阳性预测值为98.25％，高于仅凭CDFI诊断甲状腺恶性肿瘤的75.44％。结论：甲状腺肿瘤内部血供丰富程度与VEGF表达具有相关性，恶性组内部的血流丰富程度显著高于良性组，CDFI结合VEGF测定可以明显提高对甲状腺良、恶性病变鉴别的符合率。甲状腺肿瘤的CDFI检查结合VEGF测定，有可能成为术前对甲状腺肿瘤良恶性进行鉴别的一种新的方法。
目的：分析甲狀腺腫瘤綵色多普勒血流顯像（ CDFI）與血管內皮生長因子（ VEGF）測定的相關性，探討術前應用CDFI聯閤VEGF檢測鑒彆甲狀腺腫瘤良、噁性的可行性。方法：外科手術治療的甲狀腺腫瘤患者80例，術前用CDFI顯示結節內部及週邊血流信號，對血流豐富程度進行分級。術後病理標本用免疫組織化學法檢測VEGF。對病理診斷為良性和噁性的兩組病例分彆做CDFI血流分級與VEGF錶達的相關性分析，併用CDFI聯閤VEGF檢測的方法，對甲狀腺腫瘤的良、噁性進行模擬預測。結果：80例中共有96箇甲狀腺腫瘤結節，其中57箇噁性結節，39箇良性結節。良性組的CDFI血流分級明顯低于噁性組（ P ＜0.001）；良性組的VEGF多呈“＋～＋＋”錶達，噁性組VEGF多呈“＋＋～＋＋＋”錶達。 VEGF與CDFI具有相關性（P＜0.01）。 CDFI結閤VEGF分級對噁性腫瘤的暘性預測值為98.25％，高于僅憑CDFI診斷甲狀腺噁性腫瘤的75.44％。結論：甲狀腺腫瘤內部血供豐富程度與VEGF錶達具有相關性，噁性組內部的血流豐富程度顯著高于良性組，CDFI結閤VEGF測定可以明顯提高對甲狀腺良、噁性病變鑒彆的符閤率。甲狀腺腫瘤的CDFI檢查結閤VEGF測定，有可能成為術前對甲狀腺腫瘤良噁性進行鑒彆的一種新的方法。
목적：분석갑상선종류채색다보륵혈류현상（ CDFI）여혈관내피생장인자（ VEGF）측정적상관성，탐토술전응용CDFI연합VEGF검측감별갑상선종류량、악성적가행성。방법：외과수술치료적갑상선종류환자80례，술전용CDFI현시결절내부급주변혈류신호，대혈류봉부정도진행분급。술후병리표본용면역조직화학법검측VEGF。대병리진단위량성화악성적량조병례분별주CDFI혈류분급여VEGF표체적상관성분석，병용CDFI연합VEGF검측적방법，대갑상선종류적량、악성진행모의예측。결과：80례중공유96개갑상선종류결절，기중57개악성결절，39개량성결절。량성조적CDFI혈류분급명현저우악성조（ P ＜0.001）；량성조적VEGF다정“＋～＋＋”표체，악성조VEGF다정“＋＋～＋＋＋”표체。 VEGF여CDFI구유상관성（P＜0.01）。 CDFI결합VEGF분급대악성종류적양성예측치위98.25％，고우부빙CDFI진단갑상선악성종류적75.44％。결론：갑상선종류내부혈공봉부정도여VEGF표체구유상관성，악성조내부적혈류봉부정도현저고우량성조，CDFI결합VEGF측정가이명현제고대갑상선량、악성병변감별적부합솔。갑상선종류적CDFI검사결합VEGF측정，유가능성위술전대갑상선종류량악성진행감별적일충신적방법。
Objective:To analyse the correlation of color doppler flow imaging(CDFI) and vascular endothelial growth factor( VEGF) in testing thyroid tumors, and discuss the application of preoperative joint of CDFI and VEGF in order to test the feasibility of the identification of benign and malignant thyroid tumor.Methods:Preoperative application of CDFI to 80 patients with thyroid tumors showed flowing signals inside and outside the nodules and their blood flow was graded according to the amount.Postoperative pathological specimens were tested on VEGF with immune histochemical method.The specimens were tested respectively on the correlation of CDFI blood flowing grading and VEGF expression.What's more, we predicted whether the thyroid tumors were benign or malignant through simulation.Results:Out of the 80 cases, there were 96 thyroid tumor nodules, of which 57 were malignant, 39 benign.The CDFI blood flowing grading of benign group was obviously lower than that of malignant group ( P <0 .001 ); The VEGF of benign group gave the expression “ +~++”, malignant group's VEGF expression was“++~+++”.The study showed VEGF and CDFI were correlative (P<0.01).CDFI combined with VEGF grading of malignancy of positive predictive value was 98.25%, which higher than a mere 75.44%of only CDFI in the diagnosis of thyroid malignant tumor.Conclusion:The amount of thyroid tumor's blood supply is correlative with VEGF expression, and in the malignant group internal blood flowing is significantly higher than that in benign group.Therefore, along with VEGF, color doppler flow imaging can obviously help identify benign and malignant thyroid lesions.Hopefully, this method is likely to be a new preoperative identification of benign and malignant thyroid tumor.
