Yes相关蛋白在分化型甲状腺癌中的表达与发病危险因素分析

Expression of Yes-associated protein and analysis of risk factors in differentiated thyroid carcinoma

目的：分析Yes相关蛋白在分化型甲状腺癌中的表达及发病的危险因素。方法对新疆昌吉回族自治州人民医院152例分化型甲状腺癌及27例良性甲状腺肿瘤手术患者临床资料进行回顾分析，根据Yes相关蛋白在分化型甲状腺癌及良性甲状腺肿瘤中的表达，采用χ2检验和多因素非条件Logistic回归，分析Yes相关蛋白与性别、年龄、促甲状腺激素（TSH）水平、结节大小、包膜完整性、病理类型、淋巴结转移之间的关系及分化型甲状腺癌发病的危险因素。结果良性甲状腺肿瘤组Yes相关蛋白表达阳性率为66.7%（18/27），明显高于分化型甲状腺癌组（31.58%，48/152），组间比较差异有统计学意义（χ2=12.127，P ＜0.01）。光镜下， Yes相关蛋白主要位于细胞核及细胞质，其中良性甲状腺肿瘤着色较深，为强阳性或者中等阳性；分化型甲状腺癌着色较浅或者无染色，为弱阳性或者阴性。χ2检验显示，患者性别、年龄、病理类型对Yes相关蛋白表达无影响（χ2值分别为0.419、0.221、0.315，P均＞0.05）；TSH水平、结节大小、包膜完整性、淋巴结转移情况对Yes相关蛋白表达有影响（χ2值分别为4.020、8.424、4.386、6.673，P＜0.05或＜0.01），Yes相关蛋白表达为下调。多因素非条件Logistic回归分析显示，结节大小不是Yes相关蛋白表达下调的危险因素[比值比（OR）=1.929，P ＞0.05]；TSH水平高于4.5 mU/L、包膜不完整、有淋巴结转移是Yes相关蛋白表达下调的危险因素（OR分别为2.167、2.665、3.048，P均＜0.05）。结论 Yes相关蛋白在分化型甲状腺癌中表达下调；TSH水平升高、包膜不完整、有淋巴结转移是Yes相关蛋白下调及分化型甲状腺癌发生的危险因素。

Objective To analyze the expression of Yes-associated protein and risk factors in differentiated thyroid carcinoma. Methods Clinical data of 152 patients with differentiated thyroid carcinoma and 27 cases of benign thyroid tumor from Changji Hui Autonomous Prefecture People’s Hospital of Xinjiang, were analyzed retrospectively. According to the expression levels of Yes-associated protein in differentiated thyroid cancer and benign thyroid tumor, univariate Chi-square test and multivariate Logistic regression methods were used to analyze the relationship between Yes-associated protein and gender, age, thyroid stimulating hormone（TSH） level, nodule size, capsule integrity, histological type and lymph node metastasis, in order to find out risk factors in differentiated thyroid cancer. Results The positive rate of expressed Yes-associated protein in benign thyroid tumor group was 66.7%（18/27）, which was significantly higher than 31.58%（48/152） of differentiated thyroid cancer group, and the difference was statistically significant（χ2=12.127, P〈0.01）. Under an optical microscope, changes of Yes-associated protein were found to be mainly located in the nucleus and cytoplasm , and in benign thyriod tumor the degree of staining was deep, strong positive or moderately positive; differentiated thyroid carcinoma was lightly stained or no staining, weakly positive or negative. Chi-square test showed that the expression of Yes-associated protein was not affected by sex, age and pathological type（χ2= 0.419, 0.221, 0.315, all P 〉0.05）; TSH level, nodule size, capsule integrity, lymph node metastasis had an impact on the expression of Yes-associated protein which was down regulated （χ2=4.020, 8.424, 4.386, 6.673, P〈0.05 or〈0.01）. Logistic regression analysis showed that the nodule size was not a risk factor （ odds ratio , OR ） of Yes-associated protein expression （OR=1.929, P〉0.05）; TSH levels above 4.5 mU/L, lymph node metastasis and envelope incomplete were risk factors that down regulated the expression of Yes-associated protein （OR=2.167, 2.665, 3.048, all P〈0.05）.＆amp;nbsp;Conclusion Yes-associated protein is down regulated in differentiated thyroid cancer. Elevated TSH levels , incomplete capsule and lymph node metastasis are risk factors of Yes-associated protein down expression and differentiated thyroid cancer.