ARFI定量测定结节内剪切波速度(SWV)对甲状腺良恶性结节的鉴别价值

摘要

目的:研究声脉冲辐射力(ARFI)定量测定结节内剪切波速度(SWV)对甲状腺良恶性结节的鉴别价值.方法:选择2014年6月~2017年2月在海安县人民医院诊断为甲状腺结节的患者,根据穿刺活检结果分为甲状腺良性结节和甲状腺恶性结节.穿刺活检前进行ARFI弹性超声并测定SWV,穿刺活检后取活检组织并测定增殖分子、侵袭分子的表达量.结果:甲状腺恶性结节的SWV显著高于甲状腺良性结节;甲状腺恶性结节内P53、CyclinG2、E-cadherin、T IM P1、T IM P3的m RN A表达量显著低于甲状腺良性结节,FOXA1、Survivin、XIAP、Twist、Vimentin的mRNA表达量显著高于甲状腺良性结节;高SWV甲状腺恶性结节内P53、CyclinG2、E-cadherin、TIMP1、TIMP3的mRNA表达量显著低于低SWV甲状腺恶性结节,FOXA1、Survivin、XIAP、Twist、Vimentin的mRNA表达量显著高于低SWV甲状腺恶性结节.结论:甲状腺恶性结节的SWV显著升高且与癌细胞的异常增殖和侵袭密切相关.%Objective:To study the differential value of shear wave velocity (SWV) in nodules quantitatively determined by acoustic radiation force impulse (ARFI) for benign and malignant thyroid nodules .Methods:Patients who were diagnosed with thyroid nodules in the People's Hospital of Hai'an County between June 2014 and February 2017 were selected and divided into those with benign thyroid nodules and malignant thyroid nodules according to the biopsy results .Before biopsy ,the ARFI ultrasonic elastography was performed to measure SWV ,and the biopsy tissue was collected after biopsy to determine the ex-pression of proliferation molecules and invasion molecules .Results :The SWV of malignant thyroid nodules was significantly higher than that of benign thyroid nodules ;P53 ,CyclinG2 ,E-cadherin ,TIMP1 and TIMP3 mRNA expression in malignant thyroid nodules were significantly lower than those in benign thyroid nodules while FOXA 1 ,Survivin ,XIAP ,Twist and Vim-entin mRNA expression were significantly higher than those in benign thyroid nodules ;P53 ,CyclinG2 ,E-cadherin ,TIMP1 and TIMP3 mRNA expression in malignant thyroid nodules with high SWV were significantly lower than those in malignant thyroid nodules with low SWV while FOXA1 ,Survivin ,XIAP ,Twist and Vimentin mRNA expression were significantly higher than those in malignant thyroid nodules with low SWV .Conclusion:The SWV of malignant thyroid nodules significantly increases and is closely related to the abnormal proliferation and invasion of cancer cells .