瘦素及其受体在甲状腺乳头状癌中的表达与病理特征相关性研究

Relationship between Expression and Pathological Characteristics of Leptin and Its Receptor in Thyroid Papillary Carcinoma

目的探讨瘦素(Leptin)及瘦素受体即肥胖基因(obesity receptor,OB-R)在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)中的表达与病理特征相关性,为临床PTC预后评估及治疗提供依据。方法收集甲状腺腺瘤组织标本20例和PTC组织标本60例,采用SP免疫组织化学染色法检测Leptin、OB-R在PTC及甲状腺腺瘤组织中的表达,观察Leptin、OB-R在PTC及甲状腺腺瘤组织中的阳性表达情况,分析PTC中不同临床特征Leptin、OB-R的表达水平。结果 OB-R在PTC中的阳性率明显高于甲状腺腺瘤(P=0.04)。PTC中的双重表达率(46.7%)明显高于甲状腺腺瘤(20.0%,P=0.04)。Leptin、OB-R表达水平均在多发病灶、肿瘤直径≥1cm、TNM分期为Ⅲ期、Ⅳ期的患者中明显升高(P<0.05),Leptin在有淋巴转移的患者中明显增高(P<0.05),而OB-R表达则与是否淋巴转移无明显关系(P>0.05)。结论 Leptin、OB-R在PTC中存在高表达,双重表达也较普遍,在甲状腺癌发生、浸润、转移过程中起了一定作用。Leptin在PTC中具体作用机制若获得证实,则可能成为PTC预防及治疗的新靶点。

Objective To investigate the relation ship of expression and pathological characteristics of leptin and its receptor in thyroid papillary carcinoma, in order to provide basis for clinical prognosis and treating PTC. Methods Sixty eases of PTC tissue samples and 20 cases of thyroid adenoma tissue samples were collected. The expression of leptin and OB - R in PTC and thyroid adenomat issues were detected by SP immunohistochemieal staining. The positive expression of Leptin, OB - R were observed in PTC and thyroid adenoma tissues. The expression level of Leptin and OB - R in different clinical characteristics in PTC was analysised. Results The positive rate of OB - Rin PTC was significantly higher than that of thyroid adenoma （ P = 0.04）. The dual expression rate in PTC （46.7%） was significantly higher than that of thyroid adenoma （20%） （ P = 0.04）. The expression level of leptin,OB - R of patients with multiple lesions, tumor diameter≥1 em, in stage , IV stage by TNM staged were increased significantly （ P 〈 0.05 ）. The leptin level of patients with lymph node metastasis was increased significantly （ P 〈 0.05） , but there was no obvious relationship between OB - R expression and lymph node metastasis （P 〉 0.05 ）. Conclusion The high leptin and OB - R expression exists in PTC. Dual expression is common. They played a certain role in thyroid careinogenesis,invasion,transfering process. If the leptin＇s specific mechanism in PTC could be confirmed, it may be a new target for prevention and treating PTC in future.