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目的:探讨彩色多普勒血流显像(CDFI)检测甲状腺恶性肿瘤的血流情况、病理环氧化酶-2(COX-2)、微血管密度(MVD)与颈部淋巴结转移的关系。方法:选择于我院住院行手术治疗的甲状腺恶性肿瘤患者54例,根据颈部淋巴结转移情况,分为转移组和未转移组。采用CDFI检测两组患者的血流情况,并以免疫组织化学染色法对两组手术切除肿瘤标本进行COX-2、MVD检测,分析CDFI检测血流情况与COX-2表达、MVD计数的相关性。结果:转移组Vmax及RI均明显高于未转移组(P<0.01),而转移组的II、III级血流信号比例较未转移组稍大,但二者间无统计学差异(P>0.05);转移组术后切除肿瘤组织中COX-2表达阳性率、MVD计数高于未转移组,差异有显著性(P<0.01);甲状腺恶性肿瘤组织中COX-2表达与其CDFI血流分级、Vmax、RI均呈正相关(r=0.619,0.675,0.735,P<0.01),MVD计数与血流分级、Vmax、RI也均呈正相关(r=0.735,0.629,0.679,P<0.01)。结论:CDFI能有效评估患者伴发颈部淋巴结转移的可能性,对甲状腺恶性肿瘤是否伴颈部淋巴结转移提供有价值的参考信息。
Objective: To investigate the relationship between blood flow, pathological cyclooxygenase-2 (COX-2), microvessel density (MVD) and cervical lymph node metastasis by color Doppler flow imaging (CDFI) in thyroid malignant tumors. Methods: Fifty-four patients with thyroid malignant tumor who were surgically treated in our hospital were divided into metastasis group and non-metastasis group according to the metastasis of cervical lymph nodes. The blood flow of the two groups was detected by CDFI. COX-2 and MVD were detected by immunohistochemical staining in two groups of resected tumor specimens. The correlation between CDFI and COX-2 expression and MVD count was analyzed . Results: Vmax and RI were significantly higher in the metastatic group than those in the non-metastatic group (P <0.01), while those in the metastatic group were slightly larger than those in the non-metastatic group, but there was no significant difference between the two groups (P> 0.05). The positive expression rate of COX-2 in the resected tumor group was higher than that in the non-metastasis group (P <0.01). The expression of COX-2 in thyroid malignant tumor was significantly correlated with the CDFI grade , Vmax, RI (r = 0.619,0.675,0.735, P <0.01). There was a positive correlation between MVD and blood flow grade, Vmax, RI (r = 0.735,0.629,0.679, P <0.01). Conclusion: CDFI can effectively evaluate the possibility of patients with cervical lymph node metastasis, and provide valuable reference information for whether thyroid malignant tumor is accompanied with cervical lymph node metastasis.