中文摘要：

目的：探讨甲状腺功能亢进症（简称甲亢）组织中表皮生长因子受体（EGFR）基因相对表达与131I治疗预后的关系。方法入组拟行131I治疗的59例Graves甲亢患者作为实验组，平均年龄（46．46±12．95）岁，其中男性16例、女性43例；正常对照组27名，平均年龄（44．66±10．86）岁，其中男性6名、女性21名。入选者采用细针穿刺法获取甲状腺组织，应用荧光实时定量PCR法检测甲亢组织及正常甲状腺组织中EGFR基因的相对表达水平，采用t检验、方差分析及多因素分析探讨EGFR基因相对表达水平与131I治疗预后的关系。结果 EGFR基因在正常甲状腺组织及Graves甲亢组织中都有不同程度的表达；甲亢组织中EGFR的相对表达水平明显高于正常甲状腺组织（1．752±0．660 vs．0．859±0．125，t=4．328, P〈0．001）。59例Graves甲亢患者经131I治疗6个月后，失访8例，其中，甲状腺功能减退症（简称甲减）占39．2%（20/51）、完全缓解占41．2%（21/51）、未愈占19．6%（10/51），甲亢治愈率（甲减＋完全缓解）为80．4%。未愈组EGFR相对表达水平显著高于治愈组（甲减＋完全缓解）（8．092±3．887 vs．1．383±0．160, t=7．647，P〈0．001）；未愈组（8．092±3．887）EGFR相对表达水平高于完全缓解组（1．487±0．479）和甲减组（0．968±0．180）（t=7．364和8．027, P〈0．001）。Logistic回归分析显示：口服131I剂量（OR=3．456）、甲状腺质量（OR=3．853）及EGFR相对表达水平（OR=1．423）是甲亢患者131I治疗后影响治疗效果的主要因素。结论 EGFR基因的相对表达可能是预测甲亢131I治疗近期疗效及预后的指标。

英文摘要：

Objective To study the relationship between the epidermal growth factor receptor （EGFR）mRNA expression and the efficacy of 131I treatment in hyperthyroidism patients. Methods Fine needle biopsies of 59[the male to female ratio was 16∶43;mean age was（46.46±12.95） years old] Graves disease patients and 27[the male to female ratio was 6∶21;mean age was（44.66±10.86） years old] normal volunteers were collected. The mRNA expression of EGFR was detected by real-time polymerase chain reaction before treatment. T-test, analysis of variance and multivariate logistic regression analysis were applied to analyze the relationship between EGFR mRNA expression and the efficacy of 131I treatment. Results Compared with normal group, the mRNA expression level of EGFR was significantly higher in Graves disease patients（1.752±0.660 vs. 0.859±0.125, t=4.328, P〈0.001）. Six months after 131I treatment, except 8 cases were lost in following up, all of the remain 51 eligible evaluated patients were relieived from hyperthyroidism. Among them, 80.4%of patients was cured, 39.2%（20/51） became hypothyroid, 41.2%（21/51） became euthyroid, and 19.6%（10/51） remained hyperthyroid. The EGFR mRNA expression was＆amp;nbsp;significantly higher in uncured group than in cured group（8.092±3.887 vs. 1.383±0.160, t=7.647, P〈0.001）. The EGFR mRNA expression was significantly higher in uncured group（8.092±3.887） than in eu-thyroid（1.487±0.479）or hypothyroid group（0.968±0.180）（t=7.364 and 8.027, P〈0.001）. Multiple logistic regression revealed that the radioiodine dosage（OR=3.456）, thyroid weight（OR=3.853） and EGFR mR-NA expression （OR=1.423） was related to the efficacy of 131I treatment. Conclusion EGFR mRNA ex-pression may be used in evaluating the prognosis of hyperthyroidism patients after 131I treatment.