甲状腺微小乳头状癌（PTMC）发病率增长迅速，实现其侵袭性的精准评估可能会改变PTMC“发现即手术”的诊治现状，但目前尚缺乏妥善评估方法。我们发现，多模态超声成像对预测甲状腺癌侵袭性具有很高的价值，但其宏观层面评估病灶特征缺乏分子病理学的依据与支持。结合国内外进展，我们认为，探索侵袭性相关多模态超声参数的分子病理学驱动机制，将有助于实现超声无创化精准预判PTMC侵袭性。本项目拟在前期甲状腺疾患多模态超声成像研究的基础上，（1）建立PTMC多模态超声数据库；（2）在PTMC组织中筛选侵袭相关分子标志物；（3）建立多模态超声联合分子标志物评估PTMC侵袭性的模型；（4）在侵袭性相关兴趣分子过表达/敲除的PTMC动物模型水平探索相关超声模态特征的分子病理学基础。本项目从PTMC个体化临床处理的需求出发，对术前精准预判PTMC侵袭性有重要意义。

The incidence of thyroid papillary microcarcinoma(PTMC) is increasing rapidly. Accurate prediction of PTMC invasiveness may have a great impact on the current therapeutic strategy of "immediate surgery after diagnosis" which seems unnecessary and excessive since most PTMC cases are stable with low aggressiveness. While there still lacks methods for precise assessment of the progression ability of PTMC. In our previous study, we revealed that multimodality ultrasound evaluation had great potential for PTMC invasiveness prediction. However, the information acquired by this methodology reveals only physical profiles which lack connection to the innate molecular pathological status that determines the invasive ability as well as the macroscopical features of the lesions. Based on our findings and other scientists' reports, we propose that investigation of the molecular pathological basis for driving the variations of the multimodality ultrasonographic parameters of PTMC will improve the accuracy of precise assessment of PTMC invasiveness by ultrasonography. In this project, on establishment of our multimodality ultrasound database of thyroid lesions, we will, 1) set up the multimodality ultrasound database of for PTMC; 2) screen the molecular biomarkers for prediction of PTMC aggressiveness; 3) establish a predictive model for PTMC aggressiveness by combination of the multimodality ultrasound parameters and molecular biomarker status; 4) investigate the molecular pathological basis for the difference of PTMC multimodality ultrasound parameters by overexpressing/knocking out interested molecules in PTMC cells forming xenograft tumors in vivo. With the aim to satisfy the individual treatment demand of PTMC with different invasive abilities, our study has great siginificance for accurate prediction of the PTMC aggressiveness.