外周血甲状腺过氧化物酶mRNA与甲状腺乳头状癌转移风险的研究

Study on Thyroid Peroxidase mRNA in Peripheral Blood and the Risk of Papillary Thyroid Carcinoma Metastasis

目的:检测甲状腺乳头状癌(PTC)患者外周血甲状腺过氧化物酶(TPO)m RNA的表达水平,探讨其在预测PTC转移风险中的诊断价值。方法:以术后组织病理学为诊断标准,采用巢式逆转录-聚合酶链反应方法检测41例PTC患者术前外周血TPO m RNA表达阳性率,并分析其与患者临床病理学特征及转移风险的关系。结果:41例PTC患者均行全/近全甲状腺切除术联合颈部淋巴结清扫术,其中伴颈部淋巴结转移16例(39.0%),均无远处转移。将患者按照手术前血清TPO m RNA表达阳性与否分组,尽管2组间表达阳性率在性别、年龄、肿瘤最大径、肿瘤数目无显著差异(P>0.05),但伴有颈部淋巴结转移患者的表达阳性率明显高于不伴转移者(68.8%vs 36.0%,P<0.05)。对PTC患者进行术后TNM分期与复发危险度分层,TPO m RNA在不同术后分期的组间表达无显著差异(P>0.05),但在中、高危组的表达阳性率明显高于低危组(68.8%、66.7%vs 31.8%,P<0.05)。结论:外周血TPO m RNA表达水平可能有助于预测PTC转移的风险,有望成为甲状腺癌的分子标志物。

Objective： To evaluate the diagnostic value of thyroid peroxidase（TPO） mRNA in peripheral blood of papillary thyroid carcinoma（PTC） patients. Methods： Postoperative histopathology as the diagnostic standard, the expression of circulating TPO mRNA was measured by nested RT-PCR in PTC patients. Results： 41 PTC patients accepted total/subtotal thyroidectomy and cervical lymph node dissection, 16（39.0 %） had cervical lymph node metastasis, none had distant metastasis. The positive rate of TPO mRNA had no significant difference among the gender, ages, the levels of TPOAb, tumor size, the numbers of tumor in PTC patients（P〈0.05）, but had significant difference between patients with and without central lymph node metastasis（68.8% vs 36.0%, P〈0.05）. TPO mRNA expression showed no significant difference among patients of different TNM staging（P〈0.05）, but it did exhibit significantly different between low-risk patients and Intermediate/high-risk patients for recurrence（31.8% vs 68.8%, 66.7%, P〈0.05）. Conclusions： The expression of TPO mRNA in peripheral blood could serve as a potential molecular marker to predict PTC metastasis.