血清MMP-2在甲状腺乳头状癌复发或残留者中的表达研究

Expression of Serum MMP-2 in Patients with Papillary Thyroid Cancer Recurrence or Residuum

目的探讨基质金属蛋白酶(MMP)-2在甲状腺乳头状癌(PTC)复发或残留患者血清中的表达水平及其临床应用价值。方法采集2009年3月至2009年12月期间入住我科行手术治疗的68例甲状腺疾病患者的术前空腹血清和15位体检健康者的空腹血清。根据术后病理结果分为PTC伴淋巴结转移组(19例)、PTC复发或残留伴淋巴结转移组(17例)、PTC无淋巴结转移组(10例)、甲状腺良性疾病组(22例),体检健康者作为对照组(15位),采用ELISA法测定各组血清标本中MMP-2的表达水平,并分析各组MMP-2表达水平的差异。结果血清MMP-2表达水平在PTC复发或残留伴淋巴结转移组、PTC伴淋巴结转移组、PTC无淋巴结转移组、甲状腺良性疾病组及对照组中分别为(1 724.00±762.24)ng/ml、(1 329.16±776.59)ng/ml、(1 489.61±546.53)ng/ml、(1 264.87±817.27)ng/ml及(608.43±88.63)ng/ml,PTC复发或残留伴淋巴结转移组和PTC伴淋巴结转移组均分别明显高于甲状腺良性疾病组和对照组(P<0.05);PTC无淋巴结转移组仅明显高于对照组(P<0.05),而与甲状腺良性疾病组比较,差异无统计学意义(P>0.05)。甲状腺良性疾病组与对照组间比较差异也无统计学意义(P>0.05);3个恶性疾病组间MMP-2表达水平比较差异无统计学意义(P>0.05)。PTC伴淋巴结转移组、PTC复发或残留伴淋巴结转移组、PTC无淋巴结转移组、甲状腺良性疾病组及对照组的MMP-2表达阳性率分别为79%、76%、80%、41%及20%。3个恶性疾病组间阳性率比较差异均无统计学意义(P>0.05),但均分别明显高于甲状腺良性疾病组和对照组(P<0.01)。甲状腺良性疾病组的阳性率也明显高于对照组(P<0.01)。结论血清MMP-2的检测可以用于术前甲状腺包块性质判断的筛选指标;血清MMP-2水平检测不适用于判断PTC是否转移。

Objective To explore the expression of matrix metalloproteinase （MMP） -2 in patients with papillary thyroid cancer （PTC） recurrence or residuum and its value of clinical application. Methods The serums from 68 patients with thyroid disease underwent operation and 15 health examinations under stomachs empty from March 2009 to December 2009 in this hospital were gathered. Sixty-eight patients with thyroid disease were divided into PTC with lymph node metastasis （LNM） group （n=19）, PTC recurrence or residuum with LNM group （n=17）, PTC without LNM group （n 10）, and benign thyroid disease group （n=22） according to the postoperative pathological findings, 15 health examinations as control group. The expression of MMP-2 of serum sample was detected by ELISA method. The difference of the expression of MMP-2 in each group was analyzed. Results The expressions of MMP-2 in the PTC recurrence or residuum with LNM group, PTC with LNM group, PTC without LNM group, benign thyroid disease group, and the control group were （1 724. 00±762.24） ng/ml, （1 329. 16±776.59） ng/ml, （1 489.61±546. 53） ng/ml, （1 264.87±817.27） ng/ml, and （608.43 ± 88.63） ng/ml, respectively. The expressions of MMP-2 in the PTC with LNM group and PTC recurrence or residuum with LNM group were significantly higher than those in the benign thyroid disease group （P〈 0.05） and the control group （P 〈 0.05）, respectively, which in the PTC without LNM group was significantly higher than that in the control group （P〈 0.05）. There was no significant difference of MMP-2 expression of serum between the benign thyroid disease group and the control group （P〉0. 05）, which were no significant difference among the other three malignant disease groups （P〉0. 05）. The MMP-2 positive expression rates were 79%, 76%, 80%, 41%, and 20% in the PTC with LNM, PTC recurrence or residue with LNM group, PTC without LNM group, benign thyroid disease group, and control group, respectively. The MMP-2 positive expressions rates of serums were not significantly different among three malignant disease groups （P〉0. 05）, but which were significantly higher than those of the benign thyroid disease group （P〈 0. 01） and control group （P〈 0. 01）, respectively. Conclusions The MMP-2 level of serum can be used as an index to judge preoperative thyroid nodules, which can not be use to determine whether PTC metastasis or not.