甲状腺结节分子标志物与超声声学特点的联系

发布时间：2018-03-04 12:14

  本文选题：甲状腺结节　切入点：分子标志物　出处：《山东大学》2014年硕士论文　论文类型：学位论文

【摘要】：背景：目前临床上甲状腺疾病的发病率呈逐渐上升的趋势,其致病因素很多,导致了在诊断和治疗上存在误差,不利于患者的康复。如果将常规检查与分子标志物联合使用,则提升了诊断的几率。经过调查总结得出,导致发生甲状腺结节疾病发生的主要原因主要有以下几点：缺碘、致甲状腺疾病的物质(一般致甲状腺疾病的物质包括了萝卜族,食物以及土壤之中的镁、钙、锌物质,或者是饮用水的硬度过高,亦或是服用了过氯酸钾、秋水仙素、硫氰化钾、磺胺类以及氨基水杨酸等药物,进而抑制了甲状腺素的合成与释放)、激素合成受抑制(主要表现为家族性甲状腺疾病,其影响因素为遗传性酶的缺陷,进而造成激素的合成受到抑制,或是机体缺乏水解酶,造成甲状腺激素的合成和分泌受到抑制)。 目的：分析甲状腺良恶性结节的彩色多普勒超声表现及分子标志物,探讨甲状腺结节的基因表达与超声声学特点的关系,为临床上甲状腺结节的辅助治疗及预后判断提供更多的依据。 方法：随机抽取2011年1月-2012年2月于济南市第四人民医院接受手术治疗的甲状腺结节患者100例,对患者病历资料采用回顾性分析的方法。 结果：甲状腺癌的发生发展与抑癌基因p16和rb蛋白缺失有关,P16、RB在甲状腺癌中的表达明显高于甲状腺良性结节组。低回声、微钙化、Ⅲ级血流、纵横径比(≥1)及淋巴结转移这5组P16阳性表达均高于对比组,边界不清组表达差异不显著。边界不清、低回声、微钙化及Ⅲ级血流和纵横径比组(≥1)这5组RB蛋白表达阳性率均高于对照组,而淋巴结转移组RB蛋白表达与对照组无明显差异。 结论：彩色多普勒超声检查对于甲状腺结节有高敏感性,是鉴别甲状腺良恶性结节和早期诊断甲状腺癌的有效手段。甲状腺癌的病理特点和基因表达与甲状腺癌的超声特征具有一定的联系,可根据甲状腺癌的超声表现对癌灶的生物学行为和预后进行评估。
[Abstract]:Background: at present, the incidence of thyroid diseases is gradually increasing in clinic, and there are many pathogenic factors, which lead to errors in diagnosis and treatment, which is not conducive to the rehabilitation of patients. If the routine examination is used in combination with molecular markers, The main causes of thyroid nodular diseases are iodine deficiency, substances that cause thyroid diseases (the substances that cause thyroid diseases generally include radish people, etc.). Magnesium, calcium, zinc in food and soil, or high hardness in drinking water, or drugs such as potassium perchlorate, colchicine, potassium thiocyanate, sulfanilamide and aminosalicylic acid, In turn, the synthesis and release of thyroxine were inhibited, and hormone synthesis was inhibited (mainly in familial thyroid disease, which was influenced by the deficiency of hereditary enzymes, which resulted in the inhibition of hormone synthesis or the lack of hydrolase in the body. The synthesis and secretion of thyroid hormones are inhibited. Objective: to analyze the color Doppler ultrasound findings and molecular markers of benign and malignant thyroid nodules, and to explore the relationship between the expression of genes and the acoustic characteristics of thyroid nodules. To provide more evidence for clinical adjuvant treatment and prognosis of thyroid nodules. Methods: a total of 100 patients with thyroid nodules were randomly selected from January 2011 to February 2012 in Jinan 4th people's Hospital. Results: the occurrence and development of thyroid carcinoma were related to the deletion of tumor suppressor gene p16 and RB protein. The expression of P16FRB in thyroid carcinoma was significantly higher than that in benign thyroid nodule group. The positive expression of P16 in the 5 groups (鈮，

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