Researches On Relationship And Mechanism Between Differentiated Thyroid Cancer Recurrence And ～(99m)Tc-MIBI/HL91 Imaging

Research on relationship between 99mTc-MIBI scanning and recurrence of differentiated thyroid carcinoma after complete thyroidectomObjectiveTo evaluate the relationship between 99mTc-MIBI scanning results and recurrence of differentiated thyroid carcinoma (DTC) after complete thyroidectom.MethodChoose 173 cases of pathologically diagnosed post-thyroidectom DTC patients to perform 99mTc-MIBI focal two-phase static imaging. Then calculate early and delayed 99mTc-MIBI T/N ratios and elution rates through region of interest (ROI). Divide the patients into recurrence group and non-recurrence group after practicing thyroidectom, according to the follow-up detecting data of Tg, TgAb, B-mode ultrasonography, X-ray scanning and global 131I imaging. All data was performed statistically analyzed.ResultsThe detection rate of primary focal thyroid cancer among the 173 cases was 83.81%,among which, papillary carcinoma detection rate was 83.81%,while follicle carcinoma detection rate was 84.50%.No significance was observed between different pathological types (p>0.05).For DTC patients,T/N ratios and elution rates through early and delayed static imaging were 1.88±0.76,1.98±0.94 and(8±6.73)%,respectively. No significance could be viewed among pathological types (p>0.05).The 3-year recurrence rate after thyroidectom was 5.20% for all pathological types (p>0.05).For any type, T/N ratios and elution rates in early and delayed static imaging demonstrate obvious significances (p<0.05).ConclusionA certain relationship between 99mTc-MIBI scanning and recurrence of differentiated thyroid carcinoma after complete thyroidectom can be implicated through this research, deserving a further investigation.Experiment two:Research on relationship between P-gp expression and recurrence of differentiated thyroid carcinoma after complete thyroidectom ObjectiveTo evaluate the relationship between P-gp expression and recurrence of differentiated thyroid carcinoma(DTC) after complete thyroidectom.MethodChoose pathologically diagnosed post-thyroidectom DTC patients, 9 cases of recurrence within 3 years as recurrence group, another 9 cases without recurrence as control group. All patients were performed 99mTc-MIBI imaging before operation, then calculate 99mTc-MIBI elution rate through region of interest (ROI) technique. Pick cancer tissues and para-cancer tissues during operation to detect P-gp expression through immunohistochemical staining and RT-PCR technique. All data was practiced statistically analysis.ResultsP-gp expression in DTC tissues was higher than that in peripheral tissues according to outputs of immunohistochemical staining and RT-PCR. No significance could be viewed between types (p>0.05).Also, a linear relationship could be observed between P-gp expression and 99mTc-MIBI elution rate (p<0.05).P-gp expression in DTC recurrence tissue was significantly higher than that in un-recurrence tissues (p<0.05).No significance was observed between different types in P-gp expressions (p>0.05).ConclusionThe capacity of 99mTc-MIBI uptake and scavenge in DTC primary focal can be used to anticipate cancer recurrence after thyroidectom through 131I therapy, while the scavenge capacity of primary cancer focal demonstrates one of the P-gp expression mechanisms.Experiment three:Research on relationship between 99mTc-HL91 scanning and recurrence of differentiated thyroid carcinoma after complete thyroidectomObjectiveTo evaluate the relationship between 99mTc-HL91 scanning results and recurrence of differentiated thyroid carcinoma(DTC) after complete thyroidectom.MethodChoose 69 cases DTC patients to take 99mTc-HL91 focal two-phase static imaging, before calculating T/N ratios in 99mTc-HL91 early and delayed imaging stages through region of interest (ROI) technique before surgical operation. Divide the patients into recurrence group and non-recurrence group after practicing thyroidectom, according to the follow-up detecting data of Tg, TgAb, B-mode ultrasonography, X-ray scanning and global 131I imaging. All data was performed statistically analyzed.ResultsThe detecting positive rates of DTC primary focal sites through ^99mTc-HL91 early stage imaging were significantly higher (p<0.05).T/N ratios in ^99mTc-HL91 early stage imaging were obviously higher (p<0.05).And the pathological type variety shed no significant impact on the T/N ratio (p>0.05).The 3 year recurrence rate of different type DTC after thyroidectom was about 5.20%, with no significances observed between different pathological types (p>0.05).However, T/N ratios in different pathological types with ^99mTc-HL91 early and delayed imaging showed higher recurrence rates compared with those in non-recurrence group(p<0.05).Conclusion^99mTc-HL91 imaging can sensitively indicate hypoxia tissues and hypoxia extent in DTC. The T/N ratio detected through ^99mTc-HL91 early and delayed imaging has close relationship with DTC recurrence.Experiment four: Research on relationship between HIF-lαexpression and recurrence of differentiated thyroid carcinoma after complete thyroidectomObjectiveTo evaluate the relationship between HIF-lαexpression and recurrence of differentiated thyroid carcinoma(DTC) after complete thyroidectom.Method Choose 18 pathologically diagnosed post-thyroidectom DTC patients, 9 cases of recurrence within 3 years as recurrence group, another 9 cases without recurrence as control group. All patients were performed 99mTc-HL91 imaging before operation, then calculate 99mTc-HL91 elution rate through region of interest (ROI) technique. Pick cancer tissues and para-cancer tissues during operation to detect HIF-lαexpression through immunohistochemical staining and RT-PCR technique. All data was practiced statistically analysis.ResultsHIF-lαexpression in DTC tissues was higher than that in peripheral tissues according to outputs of immunohistochemical staining and RT-PCR. No significance could be viewed between types (p>0.05).Also, a linear relationship could be observed between HIF-lαexpression and 99mTc-HL91 elution rate (p<0.05).HIF-lαexpression in DTC recurrence tissue was significantly higher than that in un-recurrence tissues (p<0.05).No significance was observed between different types in HIF-lαexpressions (p>0.05).ConclusionThe capacity of 99mTc-HL91 uptake and scavenge in DTC primary focal can be used to anticipate cancer recurrence after thyroidectom through 131I therapy, while the scavenge capacity of primary cancer focal demonstrates one of the HIF-lαexpression mechanisms.