P53、P21^(ras)、Ki-67蛋白的表达及微血管密度与甲状腺癌转移关系的研究

Clinical Significance of P53、P21^(ras)、Ki-67 and MVD in Thyroid Carcinoma

目的探讨甲状腺癌中P53、P21ras、Ki-67基因的表达及微血管密度(MVD)与甲状腺癌转移的关系。方法用免疫组化SP法,检测45例甲状腺癌中P53、P21ras、Ki-67及血管标记物CD34蛋白的表达情况,并分析其与临床病理因素的关系。结果45例甲状腺癌中P53和P21ras的阳性表达率分别为22.2%和35.5%,差异无统计学意义;在发生淋巴结转移的13例甲状腺癌中P53蛋白阳性表达率为46.2%,明显高于无转移者的12.5%(χ2=5.77,P<0.05),其Ki-67分级指数有9例分布在Ⅱ~Ⅲ级;在复发病例中P53蛋白的阳性表达率为75%,明显高于未复发病例的10%(χ2=5.92,P<0.05),复发病例的Ki-67分级指数均在Ⅱ级。微血管密度计数在滤泡癌中为79.1±18.4,明显高于乳头状癌的35.4±12.1(t=2.412,P<0.05)。结论P53蛋白阳性表达的甲状腺癌患者易发生淋巴结转移及复发,P21ras及Ki-67的高表达则提示甲状腺癌可能发生淋巴结转移,甲状腺癌组织中的微血管密度与癌组织学类型有关,而与淋巴结转移无关。

Objective To study the clinical significance of P53,P21^(ras),Ki-67 and CD34 in thyroid carcinoma.Methods The expression of P53,P21^(ras), Ki-67 and CD34 were determined by immunohistochemical SP technique in 45 cases with thyroid carcinoma,and the results were analyzed.Results The expression rate of P53 and P21^(ras) was 22.2% and 35.5%,respectively,in 45 cases.The expression rate of P53 was higher in cases with lymphatic metastasis or recurrence than that in cases without lymphatic metastasis or recurrence(46.2% vs 12.5%)(75% vs 10%)(P<0.05).The Ki-67 grade index was Ⅱ-Ⅲ in nine cases with lymphatic metastasis andⅡ in cases with recurrence.The microvessel density(MVD) of the follicular thyroid carcinoma and papillary thyroid carcinoma was 79.1±18.4 and 35.4±12.1,respectively(P<0.05).Conclusion The positive expression of P53 oncoprotein in patients with thyroid carcinomas can be treated as a useful biomarker of lymphatic metastasis and recurrence.The higher expressions of P21^(ras) and Ki-67 imply lymphatic metastasis in patients with thyroid carcinomas.The microvessel density(MVD) in thyroid carcinoma is associated with the type of carcinoma.