DTC患者血清及组织中CYFRA21.1、Gal-3、VEGF的表达水平及其意义

CYFRA21.1,Gal-3 and VEGF levels in serum and tumor tissue of patients with differentiated thyroid cancer

目的探讨分化型甲状腺癌(differentiated thyroid cancer,DTC)患者血清与组织中细胞角蛋白19片段(cytokeratin fragment antigen 21.1,CYFRA21.1)、半乳凝素-3(galectin-3,Gal-3)、血管内皮生长因子(vascular endothelial growth factor,VEGF)的表达水平及临床意义。方法收集甲状腺肿瘤患者133例,分为:良性疾病组43例:甲状腺腺瘤11例、结节性甲状腺肿32例;恶性疾病组90例:甲状腺滤泡状癌(follicular thyroid carcinoma,FTC)9例,甲状腺乳头状癌(papillary thyroid carcinoma,PTC)71例,PTC伴颈部淋巴结转移(lymph node metastasis,LNM)10例。另设健康对照组30例。采用电化学发光法(electrochemiluminescence immunoassay,ECLIA)、酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测血清CYFRA21.1、Gal-3、VEGF水平,免疫组织化学SP法检测甲状腺手术标本中细胞角蛋白19(cytokeratin 19,CK19)、Gal-3、VEGF蛋白的表达。结果血清CYFRA21.1、VEGF水平在各亚组间差异均无统计学意义(均P>0.05)。甲状腺肿瘤患者血清Gal-3水平较对照组有所增高(P<0.01),但良、恶性疾病组间比较差异无统计学意义(P=0.17)。CK19、Gal-3、VEGF在恶性疾病组中表达阳性率分别为88.9%(80/90)、91.1%(82/90)、85.6%(77/90),同良性疾病组比较差异均有统计学意义(均P<0.01)。CYFRA21.1、Gal-3、VEGF血清水平与组织表达皆无相关性(r=-0.094,r=-0.016,r=0.020,均P>0.05)。结论 CK19、Gal-3、VEGF为分化型甲状腺癌可靠的组织标志物,但其血清水平不能用于甲状腺肿瘤的良、恶性鉴别。

Objective To investigate cytokeratin fragment antigen 21. 1（ CYFRA21. 1）,galectin-3（ Gal-3） and vascular endothelial growth factor（ VEGF） levels in serum and tumor tissue of patients with differentiated thyroid cancer（ DTC） and their clinical significance. Methods One-hundred-and-thirty-three patients with thyroid tumors were enrolled. Among them 43 cases were benign tumors,including 11 cases of thyroid adenoma and 32 cases of nodular goiter; 90 cases were malignant tumors,including 9 cases of follicular thyroid carcinoma（ FTC）,71 cases of papillary thyroid carcinoma（ PTC） and 10 cases of PTC with lymph node metastasis. Thirty normal subjects was included as the control group. Electrochemiluminescence immunoassay and enzyme linked immunosorbent assay（ ELISA） were used to detect the serum levels of CYFRA21. 1,Gal-3 and VEGF; immunohistochemistry SP method was used to detect the expressions of cytokeratin 19（ CK19）,Gal-3 and VEGF protein in surgical specimens. Results There were no significant differences in serum levels of CYFRA 21. 1 and VEGF among all groups（ P〉0. 05）. The serum level of Gal-3 was significantly elevated in patients with thyroid tumors（ P〈0. 01） compared to the control,but was not different between the benign and malignant cases（ P =0. 17）. The expression rates of CK19,Gal-3 and VEGF protein in tissue were 88. 9%（ 80 /90）,91. 1%（ 82 /90） and85. 6%（ 77 /90） in malignant tumors,which were all significantly higher than those in benign tumors（ P〈0. 01）. However,CYFRA 21. 1,Gal-3 and VEGF levels in serum were not correlated with their tissue expression（ r =- 0. 094,r =- 0. 016,r = 0. 020,P〉0. 05）. Conclusion Expressions of CK19,Gal-3 and VEGF are up-regulated in differentiated thyroid carcinoma,but their serum levels may not be used to differentiate malignant and benign thyroid tumors.