Ultrasonographic Features Of The Thyroid Carcinoma And Its Relationship With Pathological Findings And Molecular Markers

BackgroundThyroid cancer is a common disease, its incidence is about1-3%with an increasingtrend. So, It is important to determine the nature of thyroid nodules. With the rapiddevelopment of ultrasonic instruments and technology in recent years，Color Dopplerflow image (CDFI) and color flow has been widely applied in clinics as anondestructive，quick，and repeatable method. High resolution thyroid ultrasound is athe most sensitive checking method for thyroid disease，which can provide thediagnostic basis for the thyroid tumor surgical operation. However，due to differenttypes of pathological thyroid nodules，large differences biological characteristics,and with multiple and multi-derived characteristics，ultrasonic manifestation of somenodules is atypical, there are difficulties in diagnosis on thyroid cancer. There is acertain portion of the missed diagnosis and if you can combine a number of thyroidcancer-specific molecular marker indicators, it may improve the sensitivity andspecificity of ultrasound diagnosis and provide the basis for prognosis. Studies haveshown that processes of carcinogenesis in thyroid cancer need multi-genes multi-step.There are many genetic mutations and related cytokines. For example,hTERT,Ki-67,VEGF,Ret,P53and other tumor-related genes had been provedrelations in the occurrence and development of thyroid cancer. Therefore, the studieson the correlation between ultrasound technology and tumor-related genes mayprovide new basis for early diagnosis and prognostic assessment. ObjectiveThe aim of this study was to estimate the value of diagnosis and prognosis of colorDoppler ultrasound in patients with thyroid cancer. therefore, ultrasonographicfeatures and lymph node metastasis of the patients were detected by ultrasound andColor Doppler flow imaging (CDFI) was determined by color Doppler, this dateswere analyzed to research its relationship with expression of hTERT、Ki-67、VEGF、Ret、P53gene and pathological type.MethodsThe date of80patients with thyroid cancer whose underwent color Dopplersonographic examinations were evaluated and compared with final histopathologicaldiagnoses. the accuracy of ultrasound to thyroid was calculated. And expression ofhTERT、Ki-67、VEGF、Ret、P53gene were determined by consecutive pathologicalsection and SP immunohistochemical method. Moreover, the correlation betweenultrasonic characteristics and gene expression was analyized.ResultsUltrasonographic characteristics of thyroid malignant nodules includedin:hypoechogenicity, microcalcification, taller than wide, irregular margin, andincreased blood flow(grade Ⅲ). And the sensitivity of the five parameters inpredicting malignance in the thyroid tumor were83.3%,72.5%,66.3%,61.3%and88.8%, respectively. but the sensitivity of all five factors was95%, it was astatistically significant criterion by spss13analysis (p=0.000). Expression Positiverate of hTERT,Ki-67,VEGF,Ret and P53gene was80%,75%,84%,89%and84%,respectively. For Further comparison, positive rate of hTERT in nodules withhypoechogenicity, microcalcification, irregular margin, and increased blood flowwere more than the nodules without these features(P＜0.0001,respectively), butpositive rate of hTERT was not related to Lymph node metastasis and thetumor’diameter. Abort expression of Ki-67and VEGF gene, they were related to hypoechogenicity, microcalcification, and increased blood flow. Ret geneexpression was increased in nodules with grade Ⅲb lood flow（P=0.001）. but,expression of P53didn’t associated with the five Ultrasonographic features.Conclusions1.Ultrasonographic characteristics of thyroid cancer included in:hypoechogenicity,microcalcification, taller than wide, irregular margin, and increased blood flow.2.Color Doppler sonography in predicting malignance in the thyroid cancer has ahigh sensitivity and it is a valuable tool in assessing patients with thyroid cancers.3.Ultrasonographic patterns of thyroid carcinoma are closely relate itshistopathological changes, ultrasound features of the focus play a Significant role indiagnosis of thyroid cancer.4.Expression of hTERT,Ki-67,VEGF and Ret gene associate withultrasonographic feature in thyroid cancer,so they can provides useful information inassessing prognosis of patients with thyroid cancers.