黏附分子CD_(44)变异剪接体6在甲状腺肿瘤中的表达及其临床意义

Expression of cell adhesion molecule (CD_(44V6)) in thyroid tumors and its significance

目的 探讨CD44变异剪接体 6(CD44V6 )在甲状腺肿瘤组织的表达情况及其与肿瘤发生、发展、浸润和转移的关系。方法 采用免疫组织化学S P法检测 2 0例癌旁甲状腺组织 ,2 4例甲状腺腺瘤和 64例甲状腺癌的石蜡标本CD44V6 表达水平。结果 CD44V6 在甲状腺腺癌的表达率 ( 92 19%)显著高于甲状腺腺瘤者 ( 5 8 3 3 %,P <0 0 1) ,癌旁甲状腺组织未见表达。甲状腺中不同组织来源的滤泡细胞癌和髓样癌的CD44V6 表达差异具有显著性 ,总阳性率分别为 96 5 5 %及 5 0 0 %(P <0 0 1)。但CD44V6 表达水平在乳头状腺癌和滤泡型腺癌间差别无显著性 (P >0 0 5 )。同时发现 2例未分化癌CD44V6 表达均呈强阳性。CD44V6 的表达水平与甲状腺癌的包膜浸润和淋巴结转移有关 ,CD44V6 表达水平在包膜浸润组和未浸润组之间 ,在淋巴结转移组和非转移组之间差别有显著性 (P <0 0 1)。CD44V6 表达与患者年龄、性别、肿瘤的大小无关 (P >0 0 5 )。结论 CD44V6 的表达与甲状腺肿瘤的分化和浸润、转移显著相关 ,检测CD44V6 有助于甲状腺癌的诊断、判断预后并可能为甲状腺癌的手术和术后综合治疗决策提供新的分子生物学指标。

Objective To investigate the expression of the cell adhesion molecule (CD 44V6 ) in thyroid tumor tissue and its relationship with the pathogenesis, development, invasiveness and metastasis of the tumor. Methods Immunohistochemistry was applied to examine the expression of CD 44V6 in 20 specimens of tissue adjacent to carcinoma, 24 of thyroid adenoma and 64 of thyroid carcinoma (including 30 papillary carcinoma, 26 follicular carcinoma, 2 anaplastic carcinoma and 6 medullary carcinoma). All the specimens were paraffin-embedded. Results The expression of CD 44V6 was observed in 14 specimens of adenomas(58.33%), and 59 of carcinoma (92.19%), but was not detected in the tissue adjacent to carcinoma. The expression of CD 44V6 was significantly different between follicular epithelial carcinoma and medullary carcinoma (96.55% vs 50.0%, P<0.01). The frequency of overexpression of CD 44V6 was associated with both invasiveness and lymph node metastasis (P<0.01), but it had no relation with age, sex and tumor size (P>0.05). Conclusion It is suggested that CD 44V6 will be useful for the diagnosis of thyroid carcinoma and serves as a biological marker for local invasion and lymph node metastasis of thyroid carcinoma.