AFAI离子源质谱成像在甲状腺肿瘤诊断中的应用研究

Thyroid tumor is the most common tumor of the endocrine system. Pathology diagnosis is the gold standard for clinical diagnosis of thyroid tumors. However, differential diagnosis of benign and malignant thyroid follicular lesions is very difficult，diagnosis of papillary hyperplasia and papillary caicinoma is also difficult sometimes. There are no effective methods to differential diagnosis some follicular thyroid cancer or thyroid adenoma cases, or some papillary thyroid carcinoma and nodular goiter with papillary hyperplasia cases. Mass Spectrometry Imaging (MSI) is an emerging novel molecular imaging technology in recent years. Our study found that mass spectrometry imaging method could well applied to the differential diagnosis malignant and benign of breast tumor and lung tumor, and thus to guide operation and treatment. Therefore, we hope that mass spectrometry imaging method can be applied to study intractable cases of thyroid neoplasm. The significance of this study is to break through the clinical pathology bottleneck which relying on the morphology of tissues, as a result to diagnose cases at the molecular level and the images clearly demonstrated the organization information. The research will establish the histopathology and Imaging Mass Spectrometry diagnosis system which are complemented each other, and will build a solid foundation for rapid and accurate clinical pathological diagnosis.

甲状腺肿瘤是内分泌系统最常见的肿瘤，病理组织学是临床诊断甲状腺肿瘤的金标准，但在诊断甲状腺滤泡性腺瘤还是滤泡癌来说则非常困难，有时区别乳头状增生和乳头状癌也相当困难。质谱成像技术（MSI）是国际上新兴的分子影像技术，近年来作为一种新型的应用技术正逐渐向临床研究靠近。我们前期研究发现，质谱成像方法可以很好的应用于人乳腺肿瘤及肺肿瘤的良恶性鉴别诊断。因此我们尝试将质谱成像方法应用于甲状腺肿瘤（包括腺瘤和滤泡癌、乳头状增生和乳头状癌）的诊断研究，帮助解决甲状腺肿瘤疑难病例的诊断。本课题组已经初步建立了针对甲状腺肿瘤的质谱成像方法，并已收集各类甲状腺肿瘤100余例。本研究的意义在于突破临床病理依靠细胞与组织形态的诊断瓶颈，通过成像方法以图像形式清晰展示肿瘤分子信息，建立组织病理学与质谱成像方法相补充的系统诊断方法体系，为快速、准确获得临床诊断结果奠定坚实基础。

甲状腺肿瘤是内分泌系统最常见的肿瘤，病理组织学是临床诊断甲状腺肿瘤的金标准，但在诊断甲状腺滤泡性病变如甲状腺腺瘤还是甲状腺滤泡癌来说则非常困难。本课题通过对不同种类甲状腺组织进行质谱扫描和成像，找到了鉴别诊断各类甲状腺肿瘤的有效分子标志物，并对临床上单纯依赖病理形态学难诊断及无法诊断的病例，尤其是对甲状腺滤泡性肿瘤如甲状腺腺瘤及甲状腺滤泡癌的鉴别诊断，进行质谱成像获得了成像结果，建立了诊断标志物组，诊断敏感性及特异性均较高；建立了组织病理及质谱成像方法下相互补充的系统诊断方法体系。本课题已发表SCI文章8篇，中文期刊1篇，最高影响因子5.4分，总影响因子18.09分；本课题项目执行期间已培养博士研究生4名，均已顺利答辩；本研究课题组成员已多次投稿并参加了中华医学会病理学分会的2017、2018、2019及2020年学术年会，就研究问题及内容开展了广泛交流。