甲状腺乳头状癌uPA表达和微血管密度与颈部淋巴结转移的关系

Relationship between expression of uPA,microvessel density and cervical lymph node metastasis in papillary thyroid carcinoma

目的探讨血管新生和(或)尿激酶型纤溶酶原激活物(urokinase-typeplasmino-genactivator,uPA)的表达与甲状腺乳头状癌(papillarythyroidcarcinoma,PTC)颈部淋巴结转移的关系。方法应用免疫组织化学SP法检测PTC中uPA的表达和以CD105抗体标志的微血管密度(microvesseldensity,MVD)。结果有颈部淋巴结转移和无淋巴结转移的PTC的uPA阳性表达率分别为72.89%(43/59)和38.71%(12/31),两组间差异有统计学意义,χ2=9.96,P=0.002。59例有颈部淋巴结转移PTC的MVD值(76.18±4.98)显著高于31例无淋巴结转移者的MVD值(38.01±3.92),t=37.03,P=0.000。uPA阳性表达且具有高MVD的PTC的淋巴结转移率为92.50%,明显高于uPA阳性表达但具有低MVD组(46.67%)、uPA阴性表达但具有高MVD组(50.00%)和uPA阴性表达且具有低MVD组(40.74%),χ2=23.45,P=0.000。结论活跃的血管生成和uPA的过表达与PTC颈部淋巴结转移的发生密切相关,PTC中uPA过表达且具高MVD者越容易发生颈部淋巴结转移,这对临床筛选高危淋巴结转移病例具有重要的指导意义。

OBJECTIVE：To explore the relationship between expression of urokinase-type plasminogen activator （uPA） or microvessel density （MVD） and cervical lymph node metastasis in papillary thyroid carcinoma（PTC）. METHODS： The SP immunohistochemical stain was performed to detect uPA expression and MVD derived from microvessels marked by CD105 in 90 PTC specimens. RESULTS： The uPA positive-expression rates in tumor tissue of PTC with cervical lymph node metastasis and without metastasis were 72.89% （43/59） and 38.71% （12/31） respectively, in which the difference was statistically significant （X^2 =9.96,P=0. 002）. The MVD value of 59 PTC with cervical lymph node metastasis （76. 18 ± 4.98） was significantly higher than that of 31 PTC without metastasis （38.01 ± 3.92） （t = 37.03,P=0. 000）. The cervical lymph node metastatic rate of PTC with uPA positive-expression and high MVD value （92.50%） was significantly higher than those of PTC with uPA positive-expression but low MVD value （46.67%）, PTC with uPA negative-expression but high MVD value（50.00%） as well as PTC with uPA negative-expression and low MVD value （40.74%） （X^2=23.45,P=0.000）. CONCLUSIONS： The active angiogenesis and the overexpession of uPA in PTC is closely associated with its cervical lymph node metastasis. PTC with uPA overexpression and high MVD value is easier to cervical lymph node metastasis, which is of vital importance to guide the clinical selection of PTC with high risk for lymph node metastasis.