| Part 1To observe the diagnostic efficacy of ultrasound-guided fine needle aspiration biopsy in thyroid nodulesObjective:This study observed the diagnostic efficacy of fine needle aspiration biopsy in different sizes of thyroid nodules.The biopsy was guided with ultrasound imaging.Besides,we analyzed that whether the nodule size,ultrasound features and FNA needle sensation can predict malignant nodules.Methods:We investigated 122 patients from March 2019 to September 2020.There were 145 thyroid nodules totally.All the nodules were performed FNA in the ultrasound department of our hospital.All the nodules were removed surgically.Based on the maximum diameter in ultrasound,the nodules were divided into two subgroups(the cut-off value is 1cm).The satisfaction rates for fine needle aspiration of the two groups were calculated.Histopathology was used as the reference index,the diagnostic efficacy of FNA in different subgroups were calculated.Then compared the diagnostic value of the subgroups.Besides,we calculated the relevance of the nodule size,ultrasound features and FNA needle sensation to malignant nodules.Results:For nodules less than 1 cm in diameter,the satisfaction rate of FNA was 83.6%,and the satisfaction rate was 91.7% in another group.There was no significant difference between the two groups in satisfaction rate(P > 0.05).The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of the small nodule group and the large nodule group were(96.7%,82.4%,91.5%,90.6%,93.3%)and(95.2%,96.3%,95.6%,97.6%,92.9%)respectively,and the two subgroups had similar diagnostic efficacy(P > 0.05).FNA needle sensation,hypoechoic,irregular or lobulated margin,microcalcification and taller than wide were associated with malignant thyroid nodules(P < 0.05),while nodule size and solid component were not associated with malignant thyroid nodules(P > 0.05).Conclusion:When the biopsy was guided with ultrasound imaging,it had similar diagnostic efficacy for the two subgroups(taking 1cm as the cut-off value),and the specimen satisfaction rate of FNA was not affected by the nodule size.Both FNA needle sensation and the ultrasound features including hypoechoic,irregular or lobulated margin,microcalcification and taller than wide were of great significance in the prediction of malignant thyroid nodules.Part 2Preliminary screening of key genes in papillary thyroid carcinoma by applying the transcriptome sequencingObjective:This study was carried out by applying transcriptome sequencing to explore the transcriptional changes of papillary thyroid carcinoma.Then find the key genes and the important signaling pathways which were related to the tumor.It was helpful to elucidate the mechanism of papillary thyroid carcinoma.Besides,it was meaningful to the early diagnosis and treatment of the tumor.Methods:Transcriptome sequencing was performed in both papillary thyroid carcinoma tissue and the paracarinoma tissue.After preprocessing the original sequencing data,statistical method was used to discover the differentially expressed genes between the papillary thyroid carcinoma and the paracarinoma tissue.The functions of differentially expressed genes were noted with Gene Ontology,and the enrichment pathways of differentially expressed genes were followed by Kyoto Encyclopedia of Genes and Genomes.The protein-protein interactions of differentially expressed genes were drawn by string database.The key genes of papillary thyroid carcinoma were found by Cytoscape software and then analyze the prognostic value of key genes on an online platform.Results:We found 1333 differentially expressed genes totally in our study,including 1069up-regulated genes and 264 down-regulated genes.Go analysis found that differentially expressed genes were concentrated in 107 items of biological process significantly,such as extracellular matrix organization,extracellular structure organization,skeletal system development,chemotaxis and taxis.Differentially expressed genes were concentrated in 12 items of cellular component significantly,such as extracellular matrix,collagen-containing extracellular matrix,endoplasmic reticulum lumen,basement membrane,basolateral plasma membrane.In molecular function,differentially expressed genes were concentrated in 19 items significantly,including extracellular matrix structural constituent,calcium ion binding,glycosaminoglycan binding,structural molecule activity,calcium-dependent protein binding.KEGG analysis found that the differentially expressed genes were concentrated in 19 signaling pathways significantly,including cytokine-cytokine receptor interaction,ECM-receptor interaction,cell adhesion molecules,complement and coagulation cascades and transcriptional misregulation in cancer.Finally,we found 10 important genes related to the incidence and progress of papillary thyroid carcinoma,including SPTBN2,SYN1,SDC1,MET,NRCAM,MUC1,FN1,ITGA3,GDNF,NCAM1 separately.Among all the key genes,FN1 and ITGA3 were found being related to the prognosis of patients with thyroid carcinoma.Conclusion:Ten differentially expressed genes may closely relevant to the incidence and progress of papillary thyroid carcinoma were screened by transcriptome sequencing and bioinformatics analysis.There were two genes related to prognosis.We found that perhaps cytokine-cytokine receptor interaction was an important signaling pathway in the incidence and progress of papillary thyroid carcinoma. |
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