类肝素酶、VEGF-C、D2-40在甲状腺癌中的表达及临床意义

Expression and clinical significance of HPSE,VEGF-C and D2-40 in thyroid carcinoma

背景与目的:甲状腺癌以淋巴道转移为主,淋巴管生成在淋巴道转移中扮演了重要角色,但其生成机制尚不明确。本研究旨在探讨甲状腺癌组织中类肝素酶(heparanase,HPSE)、VEGF-C和D2-40表达与淋巴管生成的关系。方法:用免疫组织化学SP法检测77例(其中淋巴结转移者32例)甲状腺癌[包括乳头状癌(papillary thyroid carcinoma,PTC)、滤泡癌(follicular thyroid carcinoma,FTC)、髓样癌(medullary thyroid carcinoma,MTC)]患者中HPSE、VEGF-C与D2-40的表达水平,以D2-40标记淋巴管,在显微镜下计数淋巴管密度(lymphatic vessel density,LVD),并对不同类型的甲状腺癌分别进行相关性分析。结果:在各类甲状腺癌患者中HPSE、VEGF-C与D2-40均有不同程度的表达,其中以PTC表达最高(P<0.05);HPSE、VEGF-C与D2-40在不同类型甲状腺癌里面的表达情况分别为:PTC(54.9%、68.6%、12.8±5.7),FTC(37.5%、50%、8.6±1.7),MTC(20%、20%、4.9±0.8)。HPSE、VEGF-C与D2-40的表达在有淋巴结转移组均显著高于无转移组(P值分别为0.014和0.048),且三者的表达呈正相关(r=0.616,P<0.001)。结论:HPSE、VEGF-C与D2-40的表达与甲状腺癌淋巴结转移相关;HPSE和VEGF-C的表达与淋巴管生成相关。

Background and purpose：Thyroid carcinoma cells spread mainly through lymph node metastasis, and lymphangiogenesis plays an important role during the lymph node metastasis, but it is not very clear to understand the formation mechanism. This study was to investigate the correlative expressions of HPSE, VEGF-C, D2-40 and lymphangiogenesis in thyroid carcinoma. Methods：Immunohistochemistry SP method was used to detect the expressions of HPSE, VEGF-C and D2-40 in 77 patients with thyroid carcinoma including papillary thyroid carcinoma （PTC）, follicular thyroid carcinoma （FTC）,medullary thyroid carcinoma （MTC）, 32 of them with lymph node metastasis was enrolled into the study, D2-40 stained the lymphatic vessels, and lymphatic vessel density （LVD） was scanned under the light-microscope, and the correlation among the above indexes in different thyroid carcinoma types were analyzed respectively. Results：The expressions of HPSE, VEGF-C and D2-40 were observed to have a different degree in thyroid carcinoma, and the highest expression of the protein could be seen in the patients with papillary carcinoma （P〈0.05）,The expression ratios of HPSE,VEGF-C and D2-40 in different carcinoma types were 54.9%, 68.6%, 12.8±5.7 for PTC, 37.5%, 50%, 8.6±1.7 for FTC, 20% and 20%, 4.9±0.8 for MTC, respectively. There were significant different expressions of HPSE, VEGF-C and D2-40 between the patients with lymph node-positive group and node-negative group （P=0.014, P=0.048, respectively）. In addition, the expressions of them were positively correlated （P〈0.001, r=0.616）. Conclusion：HPSE, VEGF-C and D2-40 have a close relationship with lymph node metastasis, HPSE and VEGF-C are related to the lymphangiogenesis.