组织蛋白酶D在甲状腺乳头状腺癌中的表达及临床意义

Overexpression of Cathepsin D in Papillary Thyroid Carcinoma and Its Clinical Significance.

目的:研究组织蛋白酶D在甲状腺乳头状腺癌中的表达并探讨其能否成为甲状腺乳头状腺癌独立的预后因素。方法:应用免疫组化方法,对40例甲状腺乳头状腺癌、10例甲状腺滤泡型腺瘤及10例甲状腺正常组织进行了组织蛋白酶D表达的研究,并对可能影响甲状腺癌病人预后的有关因素进行了时序检验单因素生存分析。结果:19例(47.5％)甲状腺乳头状腺癌的组织蛋白酶D表达阳性,而甲状腺滤泡型腺瘤及正常组织的表达均为阴性,差异有显著性(P<0.05)。肿瘤大于4cm及有腺外侵犯者的甲状腺癌组织蛋白酶D阳性表达率(69.23％)明显高于肿瘤小于4cm及无腺外侵犯者(37.04％)(P<0.05)。经时序检验,组织蛋白酶D与甲状腺癌病人的预后并未表现出明显的相关关系。但组织蛋白酶D表达阳性病人的术后复发率为26.3％,表达阴性者复发率为14.3％,有一定的差异。结论:组织蛋白酶D在甲状腺乳头状腺癌中有一定的阳性表达率;当肿瘤大于4cm时,发生转移和侵袭的可能性明显增加,组织蛋白酶D表达阳性者其复发率有升高趋势。

Objective: To study the overexpression of cathepsin D(cath-D) and to evaluate whether it can be regar-ded as an independent prognostic factor for patients with papillary thyroid carcinoma. Methods: Cath-D ex-pression was studied by immunohistochemical staining in papillary thyroid carcinoma(n=40), normal thyroid tissue(n=10) and follicular thyroid adenoma(n=10). Statistical analysis was carried out by Chi-square test and long-rank test. Results: Overexpression of Cath-D was found in 19 of the 40 cases(47.5%) of papillary thyroid carcinomas and no positive expression was demonstrated in both the normal and the follicular adenoma speci-mens. Cath-D overexpression bears a higher incidence in cases where the tumor invasion proceeded beyond the thyroid capsule and when the diameter of the tumor was larger than 4cm. The log-rank test for overall sur-vival suggests that Cath-D was not an independent prognostic factor for papillary thyroid carcinoma. Conclu-sions: The incidence of overexpression of Cath-D was higher in papillary thyroid carcinomas than in normal thyroid tissue and in follicular adenoma. Tumours invasing beyond the thyroid capsule. The possibility of metastasis and invasion might increase significantly when the tumour is larger than 4cm in diameter.