Kai-1、Flt-4和Tiam-1在预测甲状腺乳头状癌颈部淋巴结转移中的价值

Values of Kai-1,Flt-4 and Tiam-1 in predicting cervical lymph node metastases in papillary thyroid carcinoma

目的:探讨Kai-1、Flt-4(fms样酪氨酸激酶4)和Tiam-1(T淋巴瘤侵袭转移基因)在甲状腺乳头状癌颈部淋巴结转移中的作用,寻找预测甲状腺乳头状癌淋巴结转移的分子标志物。方法:用免疫组织化学方法检测102例甲状腺乳头状癌Kai-1、Flt-4和Tiam-1表达情况,比较它们在甲状腺乳头状癌伴颈部淋巴结转移组和无转移组间的表达差异;对52例无淋巴结转移患者进行随访,了解术后颈部淋巴结转移发生率,评估Kai-1、Flt-4和Tiam-1在预测甲状腺乳头状癌伴淋巴结转移的价值。结果:甲状腺乳头状癌Kai-1、Flt-4和Tiam-1阳性率分别为61%、49%和84%,表达率均与颈部淋巴结转移有关(均P<0.01);Kai-1、Flt-4和Tiam-1表达呈正相关性;Kai-1、Flt-4和Tiam-1在预测甲状腺乳头状癌淋巴结转移的敏感度分别为90%、66%和94%,特异度分别为67%、67%和25%,准确度分别为78%、67%和49%;Kai-1在术后发生淋巴结转移组的表达率显著高于术后无淋巴结转移者。结论:Kai-1、Flt-4和Tiam-1表达异常可能与甲状腺乳头状癌颈部淋巴结转移有关,检测Kai-1和Flt-4表达情况有助于预测甲状腺乳头状癌颈部淋巴结转移。

Objective To investigate the roles of Kai-1,fms-like tyrosine kinase 4 （Flt-4）,and T lymphoma invasion and metastasis 1 （Tiam-1） in cervical lymph node metastases in papillary thyroid carcinoma （PTC） and search the molecular markers for predicting lymph node metastases. Methods The expressions of Kai-1,Flt-4,and Tiam-1 were detected by immunohistochemistry in 102 samples of PTC. Then the expression differences were compared between patients with cervical lymph node metastasis and those without lymph node metastasis. Fifty-two patients without metastasis were followed up to monitor the incidence of postsurgical cervical lymph node metastasis. The values of Kai-1,Flt-4,and Tiam-1 for predicting metastasis of PTC were assessed. Results The expression rate was 61% for Kai-1,49% for Flt-4,and 84% for Tiam-1,and was associated with cervical lymph node metastases. The expressions of Kai-1,Flt-4,and Tiam-1 proteins were positively related. The sensitivity for predicting metastasis was 90% for Kai-1,66% for Flt-4,and 94% for Tiam-1; specificity was 67%,67%,and 25%; and accuracy was 78%,67%,and 49%,respectively. The expression rate of Kai-1 was significantly higher in the group with postsurgical lymph node metastasis than in the group without metastasis. Conclusions Abnormal expressions of Kai-1,Flt-4 and Tiam-1 may be associated with cervical lymph node metastases in papillary thyroid carcinoma. Detection of Kai-1 and Flt-4 is helpful in predicting the metastases.