甲状腺肿瘤彩色多普勒血流显像与微血管密度、血管内皮生长因子表达的研究

Corrrelation among color Doppler flowing image,VEGF and MVD in thyroid tumors

目的探讨甲状腺肿瘤的彩色多普勒血流成像特点及其血管病理学基础,评价CDFI鉴别甲状腺肿瘤的临床应用价值。方法对78例甲状腺肿瘤患者,术前应用彩色多普勒血流成像检测肿瘤的血管分类,术后分别应用抗血管内皮生长因子(VEGF),抗F8多克隆抗体对组织进行免疫组织化学染色,记数肿瘤的微血管密度(microvesseldensityMVD)及VEGF染色强度。结果甲状腺癌MVD及VEGF表达强度均显著高于良性肿瘤(P<0·05)。以CDFIⅢ型诊断甲状腺癌的敏感性为53·13%,特异性100%,CDFI与MVD间具有较好的一致性,K=0·3081(P<0·01)。结论彩色多普勒血流成像可用于术前间接评价肿瘤的血管生成,为甲状腺肿瘤的诊断与鉴别诊断提供有价值的信息。

Objective To evaluate the clinical value of CDFI in differentiating thyroid tumors by studying tumors＇ vascular pathology. Methods Seventy-eight thyroid tumors were examined preoperatively with CDFI. The vascular pattern of the tumor were assessed respectively. Tumors＇ vascular endothelial growth factor（VEGF） protein and microvessels were stained immunohistochemically by using anti - VEGF and anti - Factor Ⅷ related Antigen respectively after operation . Both the microvessel density （MVD） and the imensity of VEGF staining were analysed. Result The MVD and the intensity of VEGF staining in thyroid cancers were significantly stronger than in begin thyroid tumors （ P 〈 0.05） .When CDFI pattern Ⅷ was considered as thyroid cancer, the sensitivity and specificity of detecting thyroid cancer were 53.13 %, and 100%. Consistency is better between CDFI and MVD（ k =0. 3801, P 〈 0.01 ）. Conclusion CDFI may be used to evaluate the angiogensis in thyroid tumors before operation and could provide valuable information for the differential diagnosis of thyroid tumors.