| Objective To explore the relationship between the ultrasonographic Shear wave elastographyity of thyroid papillary carcinoma and the degree of differentiation of cancer tissue,the content of fibrous tissue,the number of cancer cells and the pathological components such as sand and gravel.Materials and methodsResearch objects:Thirty patients underwent thyroidectomy in the First Affiliated Hospital of First Affiliated Hospital of Dalian Medical University,31 lesions,all lesions were preoperative cytology and pathological pathology confirmed thyroid papillary carcinoma.There were 3 males and 27 females,aged 28 to 64 years,with an average age of(44.9 ± 9.5)years.The lesion size was(0.3-2.0)cm,mean(0.93 ± 0.45)cm.2.Experimental methods:2.1 Elasticity measurement:30 patients,31 lesions,were performed within one week before the shear wave imaging and retention of image data.Using Supersonic Imagine real-time Shear wave elastography imaging ultrasound diagnostic apparatus,the same lesion was repeated three times in different directions.The three groups of data in the largest direction were calculated and the mean values were calculated.Each group of data included papillary thyroid lesions nodular elasticity(MEmax).the mean value of the minimum(MEmin),the mean of the mean(MEmean).2.2 specimens taken and sliced production:the day of surgery in the thyroidectomy after surgery,immediately by intraoperative markers,marking the warp method for the thyroid papillary thyroid nodules ultrasound measurement of the largest long axis and surgical resection of pathological specimens of cancer nodules The maximum length of the long axis of the same,select the lesion of the maximum meridian line through the pole to the next continuous interval of 0.5cm,the routine line of pages cut,the specimens were 10%fonnalin fixed,dehydrated,paraffin embedded,4?m),HE staining.2.3 Determination of the degree of differentiation and analysis of pathological components:In the low magnification(× 40)under the observation of the morphology of tissue morphology,according to changes in the characteristics of cancer cells,tissue growth,papillary branch and gravel structure to determine the thyroid nipple the degree of differentiation of cancer.Quantitative analysis was performed by Image-pro plus6.0 image analysis software.Three fields with cancer tissue structure were randomly selected from each slice on a high magnification(× 400).The area of fibrous tissue accumulation and cancer cells in each field were calculated,The number of fibrous tissue area and the number of cancer cells in the three field of view were calculated to calculate the average.2.4 Statistical method:All data were analyzed by SPSS 24.0 statistical software.The measured data were expressed as mean ± standard deviation.The independent data were used to compare the data between the two groups.The correlation between the data was Pearson correlation,And the correlation between the second class data and the measurement data was spearman rank correlation.The linear regression equation of MEmax and MEmean as dependent variable,differentiation degree,sand and gravel,collagen fiber area and number of cancer cells were established.The stepwise method was used for p<0.05,and the difference was statistically significant.Results1.The degree of differentiation of papillary thyroid carcinoma was positively correlated with MEmean and MEmax,and the results were statistically significant(p<0.05).Compared with the low differentiation group of papillary thyroid carcinoma,MEmean and MEmax of thyroid papillary carcinoma were significantly different(p<0.05).2.The number of collagen fibers and the number of cancer cells in the pathological sections were positively correlated with MEmean and MEmax,and the results were statistically significant(p<0.05).3.The number of cancer cells in the pathological sections was positively correlated with MEmean and MEmax,and the results were statistically significant(p<0.05).4.There was significant correlation between the presence and absence of psammoma bodys in MEmean and MEmax(p<0.01),Compared with psammoma bodys,MEmean and MEmax were larger in the psammoma bodys,and the results were statistically significant(p<0.05).5.In the multiple linear regression equation established with MEmean as the dependent variable,the stepwise method,the final fiber area and the presence or absence of sand and gravel into the model,the normalization coefficients were 2.341 and 2.339,respectively.The fiber area and the presence of psammoma bodys were variable independent of MEmean.6.In the multivariate linear regression equation established with MEmax as the dependent variable,the number of fiber area and the number of cancer cells were independently correlated with MEmax using the stepwise method,the final fiber area and the number of cancer cells into the model.The normalization coefficients were the variable 9.309 and 5.818 respectively.7.Compared with the poorly differentiated group of papillary thyroid carcinoma,the area of collagen fibers in the highly differentiated papillary thyroid carcinoma group was larger and the number of cancer cells was more and the results were statistically significant(p<0.05).The degree of differentiation of papillary thyroid carcinoma was positively correlated with the area of collagen fibers and the number of cancer cells,the results were statistically significant(p<0.05).8.Compared with the psammoma bodys group,the area of collagen fibers in the psammoma bodys group was larger,and the number of cancer cells was higher,and the results were statistically significant(p<0.05).There was a positive correlation between the area of collagen and the area of collagen fibers and the number of cancer cells with the psammoma bodys,and the results were statistically significant(p<0.05).9.There was a positive correlation between the presence or absence of psammoma bodys in the pathological sections(the correlation coefficient r = 0.565,p<0.05).10.The area of collagen fibers in pathological sections was positively correlated with the number of cancer cells,and the results were statistically significant(correlation coefficient r = 0.579,p<0.05).Conclusions1.Thyroid papillary carcinoma Shear wave elastography and tumor differentiation was highly positive correlation in the diagnosis of thyroid papillary carcinoma which has a certain value.2.The Shear wave elastography of papillary thyroid carcinoma is highly correlated with fiber content,the number of cancer cells and the pathological components of sand and gravel.It has certain application value in the diagnosis of papillary thyroid carcinoma.3.The degree of differentiation of thyroid papillary carcinoma is high,the modulus of elasticity is large,the degree of differentiation is low and the modulus of elasticity is small.4.The hardness of the elastic imaging tissue is positively correlated with the size of the fiber area and the number of cancer cells. |
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