TSHR,ki-67,TTF-1,Pax-8在甲状腺乳头状癌中的表达和意义

Expression and significance of TSHR,ki-67,TTF-1 and Pax-8 in palillary thyroid carcinoma

目的观察促甲状腺激素受体(TSHR)、增殖细胞相关核抗原指数(ki-67)、甲状腺特异性转录因子-1(TTF-1)、成框基因8编码的转录因子(Pax-8)在单纯甲状腺乳头状癌(PTC)、桥本氏病(HT)合并甲状腺乳头状癌、结节性甲状腺肿(NG)以及正常甲状腺组织中的表达及意义。方法选取2018年9月~2019年6月在我院内分泌科确诊并在甲状腺外科行手术治疗的患者,包括单纯甲状腺乳头状癌16例、桥本氏病合并甲状腺乳头状癌24例,结节性甲状腺肿32例及癌旁正常甲状腺组织40例。将甲状腺组织进行脱水、透明、包埋处理,分别行TSHR,TTF-1,Pax-8,ki-67的免疫组织化学染色。显微镜下观察染色结果,TSHR判读采用Tanaka定量积分法,ki-67,TTF-1,Pax-8判读方法参见文献。应用SPSS21.0软件对数据进行统计学分析,有序多分类变量采用Wilcoxon秩和检验。结果 TSHR与TTF-1在PTC组中的表达低于在NG组(P=0.000,P=0.002)中的表达,且与是否同时患有HT无关(P=0.537,P=0.556);ki-67在PTC组中的表达显著高于在NG组中的表达(P=0.000),且有淋巴结转移的PTC中,ki-67的表达更高(P=0.004),与是否患有HT无关(P=0.285);Pax-8的表达在各组中无显著差异。结论 TSHR与TTF-1在PTC中的表达低于NG和癌旁正常甲状腺组织,ki-67在PTC中的表达高于NG和癌旁正常甲状腺组织,Pax-8在不同类型甲状腺组织中表达无显著差异。

Objective To investigate the expression and significance of thyrotropic-stimulating hormore receptor,ki-67,thyroid transcription factor-1,paired box gene-8 in papillary thyroid carcinoma(PTC),Hashimoto’s disease(HT) with papillary thyroid carcinoma,nodular goiter(NG) and normal thyroid tissue.Methods From September 2018 to June 2019,confirmed patients with thyroid cancer in the endocrine Department of our hospital and operated in thyroid surgery were collected,including 16 cases of simple thyroid papillary carcinoma,24 cases of Hashimoto’s disease combined with thyroid papillary carcinoma,32 cases of nodular goiter and 40 cases of normal thyroid tissues adjacent to the carcinoma.In all the cases of papillary thyroid carcinoma,there were 8 males and 32 females;29 cases were older than 45 years,11 cases were younger than 45 years,with an average age of(49.6±11.34);10 cases were larger than 1 cm,30 cases were smaller than 1 cm,with an average age of(0.73±0.66)cm;17 cases had lymph node metastasis,23 cases had no lymph node metastasis;16 cases had PTC alone,24 cases had PTC with Hashimoto’s disease.Among the cases of nodular goiter,7 were male and 26 were female;22 cases were over 45 years old and 10 cases were under 45 years old,with an average age of(48.72±10.28);12 cases were complicated with Hashimoto’s disease and 20 cases were simple nodular goiter.After dehydration and embedding,6 paraffin sections were cut from each wax block,and the positive expression of TSHR,ki-67,TTF-1 and Pax-8 were measured by immunohistochemistry SP method,one was stained with HE and the other with PBS solution.Tanaka quantitative integration method is used for TSHR interpretation,and ki-67,TTF-1 and Pax-8 interpretation methods are shown in the literature.Wilcoxon’s rank sum test was performed to analyze the ordinal variables.Results The positive expression of TSHR and TTF-1 in thyroid malignant tumor was lower than that in thyroid benign nodule(P=0.000,P=0.002),which was not related to HT(P=0.537,P=0.556).The expression of ki-67 in thyroid malignant tumor was significantly higher than that in thyroid benign nodule(P=0.000),The expression of ki-67 was higher in PTC with lymph node metastasis(P=0.004).There was no significant difference in the expression of Pax-8 in each group. Conclusions The expression of TSHR and TTF-1 in PTC was lower than that in NG and paracancerous normal thyroid tissues.The expression of ki-67 in PTC was higher than that in NG and paracancerous normal thyroid tissues.There was no significant difference in the expression of Pax-8 in different types of thyroid tissues.