甲状腺乳头状癌患者血清、癌组织中p53、Fas、TNF-α和Cyclin E的表达及临床意义

Expression of P53,Fas,TNF-α and Cyclin E with carcinoma papillary thyroid cancer patients in serum and its clinical significance

目的:观察肿瘤抑制基因(p53)、细胞凋亡信号受体(Fas)、肿瘤坏死因子-α(TNF-α)和细胞周期素E(Cyclin E)在甲状腺乳头状癌患者血清及癌组织中的表达,探讨其与甲状腺乳头状癌临床病理特征的关系。方法:选取穿刺确诊为甲状腺乳头状癌的住院患者作为实验组(n=74)、同期体检健康人作为正常对照组(n=26)。两组均空腹抽取静脉血,实验组于术后留取癌组织、癌旁正常组织及术后7 d再次空腹抽取静脉血。采用酶联免疫法检测血清、癌旁正常组织及癌组织中p53、Fas、TNF-α和Cyclin E蛋白的含量;采用实时荧光定量法检测甲状腺乳头状癌组织及癌旁正常组织中p53、Fas、TNF-α和Cyclin E的基因表达水平;采用免疫组织化学方法检测甲状腺乳头状癌组织及癌旁正常组织中p53、Fas、TNF-α和Cyclin E的蛋白阳性表达强度;分析其表达与甲状腺乳头状癌的临床分期、病理类型及有无淋巴结转移的关系。结果:甲状腺乳头状癌患者血清中p53、Fas和TNF-α的蛋白含量明显低于正常对照组,Cyclin E的蛋白含量明显高于正常对照组,差异均有统计学意义(P<0.01);甲状腺乳头状癌患者癌组织中p53、Fas和TNF-α的蛋白含量、蛋白阳性表达强度及基因表达水平明显低于癌旁正常组织,Cyclin E的蛋白含量、蛋白阳性表达强度及基因表达水平明显高于癌旁正常组织,差异亦均有统计学意义(P<0.05)。结论:p53、Fas和TNF-α在甲状腺乳头状癌组织中表达水平下调和Cyclin E表达水平上调,可能在甲状腺乳头状癌浸润和转移中起重要作用。四者的联合检测可作为早期诊断甲状腺乳头状癌的标记物,提高甲状腺乳头状癌的早期诊断率。

Objective：To observe the expression of the tumor suppressor gene（P53）,apoptosis signal receptor（Fas）,tumor necrosis factor alpha（TNF-α） and Cyclin E（Cyclin E） in serum and cancer tissues with papillary thyroid cancer patients,and explore their relationship with the clinical pathology characteristics of thyroid papillary carcinoma. Methods： The puncture diagnosis in patients with papillary thyroid carcinoma as the experimental group（n = 74）,physical examination of healthy people as the normal control group（n =26）. The two groups were fasting venous blood samples,the experimental group in postoperative specimens from cancer tissue,adjacent normal tissue and 7 days after the fasting venous blood was sampled again. Protein content of P53,Fas,TNF-α and Cyclin E was detected by ELISA in serum,cancer adjacent normal tissue and cancer tissue;using real-time fluorescent quantitative assay to observe the gene expression of P53,Fas,TNF-α and Cyclin E in thyroid papillary carcinoma and adjacent normal tissues; protein expression by immunohistochemical methods in papillary thyroid carcinoma and adjacent normal tissues P53,Fas,TNF-α and Cyclin E analysis; the clinical expression with papillary thyroid cancer staging,pathological Type and has no relationship to lymph node metastasis. Results：The protein concentration in serum of patients with papillary thyroid carcinoma P53,Fas and TNF-α were significantly lower than that of the normal control group,Cyclin E protein content was significantly higher than that of normal control group,the differences were statistically significant（P〈0. 01）; thyroid papillary carcinoma P53,Fas and TNF-α protein content,protein expression strength and gene expression levels were significantly lower than the normal tissues adjacent to cancer,protein content,Cyclin E protein expression and gene expression intensity was significantly higher than that in normal tissues,the difference was statistically significant（P〈0. 05）. Conclusion： The expression of p53,Fas and TNF-α in papillary thyroid carcinoma lower and expression level of Cyclin E increase,may play an important role in papillary thyroid cancer invasion and metastasis. Combined detection of the four can be used as markers for early diagnosis of papillary thyroid cancer,enhance the rate of early diagnosis of thyroid papillary carcinoma.