An improved quantitative measurement for thyroid cancer detection based on elastography

Objective

To evaluate color thyroid elastograms quantitatively and objectively.

Materials and methods

125 cases (56 malignant and 69 benign) were collected with the HITACHI Vision 900 system (Hitachi Medical System, Tokyo, Japan) and a liner-array-transducer of 6–13 MHz. Standard of reference was cytology (FNA—fine needle aspiration) or histology (core biopsy). The original color thyroid elastograms were transferred from red, green, blue (RGB) color space to hue, saturation, value (HSV) color space. Then, hard area ratio was defined. Finally, a SVM classifier was used to classify thyroid nodules into benign and malignant. The relation between the performance and hard threshold was fully investigated and studied.

Results

The classification accuracy changed with the hard threshold, and reached maximum (95.2%) at some values (from 144 to 152). It was higher than strain ratio (87.2%) and color score (83.2%). It was also higher than the one of our previous study (93.6%).

Conclusion

The hard area ratio is an important feature of elastogram, and appropriately selected hard threshold can improve classification accuracy.     

腔内超声探头在甲状腺介入性超声中的应用价值

目的探讨腔内（阴道）超声探头在甲状腺介入性超声中的应用价值。方法对16例患者分别进行甲状腺局部注射药物、组织活检及囊肿介入性治疗,均使用腔内超声探头实时引导,未用穿刺架。结果所有操作均顺利完成,甲状腺和穿刺针都能清晰显像,术中疼痛较轻,无其余不适,术后均未见出血、颈部不适等不良反应。结论腔内超声探头具有体积小、频率高、视野宽、操作灵活、工作效率高的优点,非常适合于引导甲状腺的介入性操作,值得推广应用。     

甲状腺功能异常与脑出血急性期出血量的相关性分析

目的探讨甲状腺功能异常与脑出血急性期出血量的相关性。方法将220例脑出血急性期患者根据患者有无甲状腺功能异常分为试验组(甲状腺功能异常组)和对照组(甲状腺功能正常组)各110例。要求所有患者接受控制血压、维持呼吸道通畅、保护脑细胞、脱水降颅压以及维持电解质平衡等针对急性脑出血的常规治疗。常规化验2组患者的血清三碘甲状腺原氨酸(T3)、甲状腺素(T4)、游离T3(FT3)、游离T4(FT4)、促甲状腺激素(TSH)水平,比较2组患者出血及预后情况。结果脑出血急性期试验组患者血清T3、FT3水平明显低于对照组,血清T4、FT4、TSH明显高于对照组,差异均有统计学意义(P<0.05)。试验组中大量出血者明显多于对照组,而小量出血者明显少于对照组(P均<0.05)。试验组患者平均出血量显著高于对照组,病死率高于对照组,痊愈率显著低于对照组(P均<0.05)。此外,试验组中甲状腺功能轻度异常者和重度异常者除在小量出血一项上无明显差异外,其余各项差异明显(P<0.05)。结论甲状腺功能异常与脑出血患者的病情程度明显相关,重度异常患者出血量多,病死率高。     

甲状腺自身抗体测定在亚临床甲状腺功能亢进症中的意义

目的　研究甲状腺自身抗体在亚临床甲状腺功能亢进症(简称甲亢)中的意义。方法　以51名健康人为对照,对86例亚临床甲亢患者用微粒子酶免疫法(MEIA)测定甲状腺球蛋白抗体(TGAb)和甲状腺过氧化物酶抗体(TPOAb)。结果　在亚临床甲亢患者中TGAb、TPOAb阳性率和数值明显增高,对其中73例进行12~18个月的随访发现,临床甲亢(11% )和临床甲状腺功能减退症(23% )的发生率较高。结论　测定甲状腺自身抗体对指导亚临床甲亢的治疗具有重要意义。     

甲状腺癌细胞系方波电脉冲基因转染条件的探讨

目的：探讨方波脉冲基因电转染对人甲状腺癌细胞系的转染条件和效果。方法：选用pEGFP-Cl作为外源基因与方波电脉冲相结合，以人甲状腺癌细胞系TA-K为导入对象，探讨方波脉冲基因电转染对人甲状腺癌细胞系转染的脉冲幅度，脉冲时值，脉冲次数和反应体系大小。结果：当脉冲幅度在60V／mm时，开始出现阳性细胞，脉冲时值20ms时，基因转染效率可高达35％，细胞生存分数55％，脉冲时值20ms、次数1次转染效率高、细胞死亡率低。200μl混合液电转染后观察，对细胞生存影响不大。结论：脉冲幅度在60V／mm，脉冲时值20ms，脉冲次数1次，反应体系200μl，可以为人甲状腺癌细胞系的转染提供良好效果。     

Association between thyroid hormone levels and frailty in the community-dwelling oldest-old: a cross-sectional study

Background:Changes in thyroid hormone levels are commonly recognized characters among the elderly, which were reported to potentially influence incident frailty. Therefore, we examined the cross-sectional associations of thyroid hormones (THs) with frailty as well as the five components characterizing frailty (fatigue, resistance, ambulation, number of illnesses, and loss of weight) among the oldest-old.Methods:Four hundred and eighty-seven community-dwelling oldest-old from a local community in Haidian District, Beijing, participated in our recruitment campaign between April 2019 and May 2020. The primary outcomes were a definitive diagnosis of frailty according to the FRAIL scale (Fatigue, Resistance, Ambulation, Illnesses, Loss of weight) and a positive score for each frailty subdomain. Demographic information (age, sex, marital status, and educational status), comorbidities, and details on the participants’ lifestyles were recorded. Serum THs including free triiodothyronin (fT3), triiodothyronine (T3), free thyroxine (fT4), and thyroxine (T4) and thyroid stimulating hormone (TSH) levels were also measured at the beginning of our study. Logistic regressions were conducted to screen for potential risk factors for frailty and its subdomains.Results:Among the total 487 subjects at enrollment, 60 (12.23%) of them were diagnosed with subclinical hypothyroidism and 110 (22.59%) of the total population scored positive for frailty. Logistic regression analyses adjusted for all potential confounders, showed that frailty was significantly associated with the serum TSH concentration (odds ratio [OR]: 1.06), fT3 concentration (OR: 0.54), and subclinical hypothyroidism score (OR: 2.18). The association between fT4 and frailty was absent in our observational study. The fT3/fT4 ratio characterizing peripheral hormone conversion was also tested to be correlated with frailty.Conclusion:Subclinical hypothyroidism, higher TSH level, lower fT3 level, and decreased fT3/fT4 ratio were all associated with frailty assessed by the FRAIL scale among the community-dwelling oldest-old, suggesting a relevant role of thyroid function in aging. Future longitudinal studies are warranted to determine the casual relationship between thyroid dysfunction and frailty in the oldest-old.     

青岛地区1306例甲状腺癌的临床病理特征分析

背景与目的：甲状腺癌(thyroid cancer,TC)发病率在全球范围不断攀升,但存在地区差异。该研究旨在探讨青岛这一典型东部沿海城市的TC发病情况和临床病理特点,以及该地区近年来甲状腺手术疾病谱的变化。方法：回顾性分析青岛大学附属医院2014年行甲状腺切除术的2251例甲状腺结节患者,对其中1306例TC患者的临床病理特征进一步统计分析,并与该院前期数据及美国Surveillance Epidemiology End Results(-SEER)数据库比较。结果：随着该院甲状腺手术例数的逐年上升,其中TC的比例亦由2010年的34.8%上升至2014年的59.0%。TC高发于20～54岁年龄段,较SEER数据库前移(U=2289,P=0.000),男女比例为1∶2.80,其中超重和肥胖者占50.2%。78.2%的TC患者初诊时无明显临床症状或体征,16.6%已有可看到或摸到的甲状腺结节,仅有5.2%因声音嘶哑或其他压迫症状就诊。2014年微小癌占该院TC的61.7%,较2010年(37.7%)明显增多。该院TC伴有颈部淋巴结转移者比例明显高于SEER数据库(49.5%vs 26%,χ2=11.806,P=0.001),且微小癌伴有颈部淋巴结转移率亦高达31.3％。TC各病理类型所占比例分别为：乳头状癌97.5%、滤泡癌1.1%、髓样癌1.0%、未分化癌0.5%,乳头状癌比例略高于SEER数据库(U=4654.5,P=0.055)。结论：青岛地区甲状腺手术逐年增多,TC术前诊断准确率逐年提高。该地区TC发病呈相对年轻化、超重化及高淋巴结转移趋势。微小癌比率增高提示该地区筛查及体检等预防意识的普及,微小癌中较高的淋巴结转移率提示该地区微小癌的侵袭性不容忽视。     

18F-FDG PET/CT显像偶发甲状腺癌的葡萄糖代谢与临床病理学的相关性研究

背景与目的：18F-FDG PET/CT的广泛应用导致偶发甲状腺癌的比例明显增加,偶发甲状腺癌灶的糖代谢与甲状腺癌病理学的相关性尚不清楚。研究因非甲状腺疾病行18F-FDG PET/CT显像、偶发甲状腺癌的患者,分析甲状腺癌灶的糖代谢与肿瘤的分化程度、淋巴结转移的相关性。方法：回顾性分析18F-FDG PET/CT显像偶发甲状腺瘤患者195例,53例患者手术病理诊断为甲状腺癌。分别测量甲状腺癌灶的最大标准摄取值(SUVmax)、病变大小、病变个数,同时测量患者正常甲状腺组织的SUVmax。通过病理分析病理学分型、淋巴结转移,患者分为G1组(分化型甲状腺癌)、G2组(非分化型甲状腺癌)、G3组(甲状腺癌无淋巴结转移)和G4组(甲状腺癌有淋巴结转移)。分析G1组与G2组、G3组与G4组间甲状腺癌灶的糖代谢的差异。结果：53例患者中,PET显像发现甲状腺癌灶53个。病理学发现甲状腺癌灶62个,乳头状甲状腺癌37例,滤泡状甲状腺癌4例,髓样癌9例,低分化癌3例。正常甲状腺组织的SUVmax为1.51±0.30,G1组(41例)SUVmax为4.25±1.70,G2组(12例)SUVmax为6.34±2.45,G1组和G2组的SUVmax均显著高于正常甲状腺组织(t=11.0,t=7.10,P<0.01),但G1组与G2组的SUVmax差异无统计学意义(t=3.61,P>0.05)。G3组(29例)的SUVmax为4.77±2.15,G4组(24例)的SUVmax为4.67±2.02,差异无统计学意义(t=0.33,P=0.56)。结论：18F-FDG PET/CT显像偶发癌分化型甲状腺癌、非分化型甲状腺癌均具有高糖代谢改变;不同分化程度、淋巴结转移能力的甲状腺癌灶的糖代谢水平差异无统计学意义。