The Study Between Two-dimensional And Contrast-enhanced Ultrasound Features Of PTC And Cervical Lymph Node Metastasis And Preliminary Study Of LncRNA-PVT1

Objective:To study the relationship between the features of conventional ultrasound,contrast-enhanced ultrasound?CEUS?and quantitative parameters,clinical features and cervical lymph node metastasis in papillary thyroid carcinoma?PTC?.Preliminary study the relationship between the ultrasonographic and clinical features of papillary thyroid carcinoma and the expression levels of long non-coding RNA-PVT1?LncRNA-PVT1?Methods:From October 2016 to January 2019,322 patients with PTC who were admitted to our hospital and confirmed by pathology were routinely performed ultrasound and contrast-enhanced ultrasound in our hospital before operation.The data were complete.According to the postoperative pathological results,137 cases were cervical lymph node metastasis group and 185 cases were non-metastasis group.Retrospective analysis of the relationship between ultrasound and clinical features and cervical lymph node metastasis,and the zoning of metastatic lymph nodes were analyzed.95 cases of PTC nodules were divided into?1cm group and<1cm group according to the nodule size.Quantitative analysis of CEUS was performed on the two groups.Draw the time-intensity curve?TIC curve?of the nodules,and the quantitative parameters were recorded.The relationship between CEUS quantitative parameters and PTC cervical lymph node metastasis was analyzed separately.The t-test was used for the measurement data,the?² test was used for the count data,the rank sum test was used for the grade data,and the stepwise forward logistic regression analysis was used for the multivariate analysis.P<0.05 was considered statistically significant.From May 2018 to February 2019,patients with PTC undergo surgical operated and confirmed by pathology.PTC tissues and normal thyroid tissue specimens at least 2cm from the tumor were collected and stored in liquid nitrogen.The ultrasound and clinical features of PTC were recorded in detail.The 19 PTCs were selected as the research object.Real-time quantitative PCR was used to detect the expression level of long-chain non-coding RNA-PVT1 in PTC cancer tissues and adjacent normal gland tissues.The experimental data were analyzed by 2^-??CTmethod.The relationship between PTC ultrasound and clinical features and LncRNA-PVT1 expression level was discussed.Measurement data were analyzed by t test,P<0.05 was considered statistically significant.Results:?1?Univariate analysis showed:There were significant differences in gender?P=0.041?,age?P<0.001?,nodule size?P<0.001?,calcification?P=0.035?,contact with the capsule?P<0.001?,multifocality?P=0.038?,and capsule integrity?P=0.001?between the lymph node metastasis group and the non-metastasis group.There was a statistically significant difference in the range of contact with the capsule between the two groups?P<0.001?,and the larger the contact area of the capsule,the higher the rate of lymph node metastasis.?2?Multivariate regression analysis showed that age?OR=4.666?,nodule size?OR=3.203?,capsule integrity?OR=2.189?,multifocality?OR=2.407?were independent risk factors of cervical lymph node metastasis in PTC.?3?The relationship between the quantitative parameters of PTC nodules and cervical lymph node metastasis showed that in the nodule<1cm group,There were no significant differences between the metastatic group and the non-transfer group?P>0.05?;in the group with PTC nodule size?1cm,the PI and AUC values in the metastatic group were higher than those in the non-metastasis group?24.373±5.218vs20.863±3.144,729.748±191.783vs594.637±108.102?,the difference was statistically significant?P=0.029,0.021,respectively?,the difference of the remaining quantitative parameters were not statistically significant?P>0.05?.?4?The metastasis rates of cervical lymph nodes?^?in 137 patients with PTC were 2.2%,16.8%,35.8%,35.8%,15.3%,and 83.2%,respectively,and the difference was statistically significant?P<0.001?.There were no significant differences between the districts?and?,?and??P>0.05 respectively?,and the differences among the other metastatic regions were statistically significant?P<0.05?.?5?The expression level of LncRNA-PVT1 of PTC was related to capsule integrity?P=0.030?,cervical lymph node metastasis?P=0.018?.Conclusion:?1?Cervical lymph node metastasis of PTC patients is related to gender,age,nodule size,microcalcification,contact with the capsule and contact range,multifocality,and capsule integrity;The nodule size?1cm,multifocal carcinoma,and capsule rupture are independent risk factors for cervical lymph node metastasis in PTC patients.?2?PTC nodules with maximum diameter?1 cm CEUS quantitative parameters PI,AUC are related to cervical lymph node metastasis.?3?The?area of the neck is the site with the highest incidence of PTC lymph node metastasis,followed by the neck?and?areas,involving less of the?and?areas,and rarely involving the?area.?4?The differential expression of LncRNA-PVT1 may be related to PTC membrane invasion and cervical lymph node metastasis,suggesting that the expression of LncRNA-PVT1 may be related to the aggressive behavior of PTC.