血浆β-Cat蛋白浓度作为甲状腺癌患者诊断标志物的可行性评价

FFeasibility evaluation of plasma β- catenin protein concentration as diagnostic marker for patients with thyroid cancer

目的：临床上仍在探索甲状腺疾病诊断的新方法，随着新型生物标志物的不断发现，临床上已经有关于采用免疫组织化学方法检测肿瘤病灶中标志物β-Cat蛋白表达与甲状腺癌患者肿瘤分期、淋巴结转移以及肿瘤细胞分化程度关系的研究，而对于血浆中B-Cat蛋白的报道较少，本研究旨在分析血浆中β-Cat蛋白浓度，并对其作为结节性甲状腺肿以及甲状腺乳头状癌患者诊断标志物的可行性进行探讨。方法：收集我院2013年05月至2015年07月内科收治的106例甲状腺疾病患者（其中结节性甲状腺囊肿患者50例，甲状腺乳头状癌患者56例）及50例体检正常健康人群的甲状腺组织和血液样本，采用免疫组织化学方法对采集的组织进行鉴定，采用酶联免疫分析方面测定样本中β-Cat蛋白浓度。结果：甲状腺乳头状癌组患者β-Cat免疫组织化学检测阳性率显著高于结节性甲状腺囊肿组和对照组（P〈0.01），甲状腺乳头状癌组和结节性甲状腺囊肿组患者血浆β-Cat蛋白浓度显著高于对照组（P〈0.01），而甲状腺乳头状癌组与结节性甲状腺囊肿组血浆β-Cat蛋白浓度差异不显著（P〉0.05），AUC分析结果表明β-Cat面积比例为0.721。结论：本研究结果表明，采用免疫组织化学方法检测甲状腺癌患者病灶组织中β-Cat能对甲状腺癌症患者进行准确诊断，而由于结节性甲状腺囊肿等血清β-Cat蛋白浓度与甲状腺癌症患者差异不显著，因此血浆β-Cat不能作为甲状腺癌患者临床诊断的肿瘤标志物。

Objective：New diagnostic methods for thyroid diseases are still being searched for. Immunohistochemical diagnosis is expanded by the introduction of new biomarkers including？-catenin （β-Cat）. Associations are indicated between the cellular expression of this biomarker and tumor stage, nodal metastases and the degree of tumor cell differentiation. Reports are scarce regarding the plasma level of this biomarker in malignant neoplastic diseases. The aim of the study was to analyze the plasma β-Cat concentration and the possibility of it use in the diagnostics of patients with nodular goiter and papillary thyroid carcinoma. Methods：106 case of patients treated in our hospital was selected in this study. Tissue/Plasma β-Cat concentration was determined in 106 patients with goiter and 50 healthy volunteers by immunohistochemical and ELASE method. The final histopathological examination revealed 56 cases of papillary thyroid carcinoma （PTC） and 50 cases of nodular goiter （NG）.Results： β-Cat positive rate of immunohistochemical method in PTC group was significantly higher than that of NG and control group （P〈0.01）. A significant increase in β-Cat in both groups compared to the control group （P 〈0.05）. No differences in the concentrations of biomarker was demonstrated between the PTC and NG groups. After determining the AUC for the tested biomarker, the β-Cat ratio of the area value 0.721 was the strong diagnostic test.Conclusions：Changes in the tissue β-Cat concentration can be the biomarker of thyroid cancer but it cannot be used for the detection of papillary thyroid carcinoma because of concomitant tumor-like lesions in the thyroid gland.