日照市沿海地区甲状腺癌临床病理特点及肿瘤因子表达的意义

Analysis on the clinicopathology characteristics and clinical significance of HIF-1α, VEGF and VEGF-C expression in thyroid carcinomas in Rizhao coastal district

目的研究沿海地区甲状腺癌与碘营养及HIF—1α、VEGF和VEGF—C的关系。方法分析日照市沿海地区2004年1月至2008年12月间甲状腺癌的检出率，调查饮食结构碘变化，随机选取70例甲状腺乳头状癌（PTC）、64例甲状腺腺瘤（TA）和70例结节性甲状腺肿（NG）免疫组化检测HIF-1α、VEGF和VEGF—C的表达。结果①5年甲状腺癌总检出率0．63％，年检出率随机分布；PTC中微小癌2004年后占61．29％，高于2000年前11．34％（P〈0．05）；②碘饮食比重增加；③HIF-1α、VEGF和VEGF-C在PTC中的表达均明显高于TA、NG（P〈0．05），在PTC中淋巴结转移组中的表达高于未转移组（P〈0．05），三种因子表达正相关（P〈0．05）。结论13照市沿海地区2004年后甲状腺癌发病率增加，一方面与诊断水平提高、微小癌检出率增加有关，另一方面推测与碘饮食增加及HIF-1α、VEGF和VEGF-C表达上调共同参与癌变和淋巴结转移有关，这还需进一步研究。

Objective To study the clinicopathology characteristics and clinical significance of HIF- 1α, VEGF and VEGF-C expression in papillary thyroid carcinoma（PTC） in Rizhao coastal district. Methods A statistic analysis was performed on materials of 253 cases thyroid carcinomas in two Hospitals in Rizhao area. HIF-1α,VEGF and VEGF-C expression were detected by immunohistoehemical S-P method in 70 patients of PTC ,64 patient s of thyroid adenoma（TA） and 70 patients of nodular goiter（NG）. Results The thyroid carcinoma average biopsy ratio was 0.63%. The total detection rate of thyroid carcinoma changed randomly. The expression of HIF-1α, VEGF and VEGF-C in PTCs was higher than that in TAs and in NGs （ P 〈0. 05 ） and was higher in PTCs with lymph node metastasis than that without metastasis（ P 〈 0. 05 ）. VEGF and VEGF-C expression had a positive correlation with HIF-1α（P 〈 0. 05 ）. Conclusion The incidence of TC tends to increase after 2004 in Rizhao coastal distric, the change in biopsy ratios may be related with the diagnosis level markedly improved, the detection rate increased in Thyroid microcarcinoma, and ingesting a great deal of iodine and HIF- 1α, VEGF and VEGF-C expression significantly increased. These needed further study.