表皮生长因子受体、自噬相关蛋白5、p62蛋白在甲状腺乳头状癌合并颈部淋巴结转移中的表达及临床意义

Expression and clinical significance of epidermal growth factor receptor,autophagy related protein 5,p62 in papillary carcinoma of thyroid with cervical lymph node metastasis

目的分析表皮生长因子受体(EGFR)、自噬相关蛋白5(ATG5)、p62在甲状腺乳头状癌(PTC)合并颈部淋巴结转移患者中的表达及意义。方法取80例PTC患者的PTC组织及相应的癌旁正常组织,同时取其中合并颈部淋巴结转移的45例患者的转移淋巴结组织标本。免疫组化法检测PTC组织、转移淋巴结组织和癌旁正常组织中EGFR、ATG5、p62蛋白的表达情况,及其与PTC患者临床特征及生存情况的关系。结果PTC组织和转移淋巴结组织中EGFR、p62蛋白的阳性表达率均高于癌旁正常组织,ATG5蛋白的阳性表达率低于癌旁正常组织,差异均有统计学意义(P﹤0.05)。不同TNM分期和淋巴结转移情况PTC患者PTC组织中ATG5蛋白阳性表达率比较,差异均有统计学意义(P﹤0.05);不同分化程度、TNM分期和淋巴结转移情况PTC患者PTC组织中p62蛋白阳性表达率比较,差异均有统计学意义(P﹤0.05)。Spearman相关分析结果显示,PTC组织和转移淋巴结组织中,ATG5的表达与p62呈负相关(P﹤0.01)。对80例PTC患者进行为期3年的随访,病死22例,3年生存率为72.50%(58/80)。p62阳性表达PTC患者的3年生存率为65.52%,低于阴性表达患者的90.91%,差异有统计学意义(P﹤0.05)。Cox风险比例回归模型结果显示,TNM分期、淋巴结转移、EGFR阳性表达、p62阳性表达为PTC患者预后的独立危险因素(P﹤0.05),ATG5阳性表达为PTC患者预后的独立保护因素(P﹤0.05)。结论PTC组织及淋巴结转移组织中EGFR、p62的阳性表达率较高,ATG5的阳性表达率较低,此外,ATG5及p62与PTC生物学行为有关,可能成为PTC诊断的潜在指标。

Objective To analyze the expression and significance of epidermal growth factor receptor(EGFR),autophagy related protein 5(ATG5),and p62 in patients with papillary carcinoma of thyroid(PTC)and cervical lymph node metastasis.Method Take 80 cases of PTC patients’PTC tissues and corresponding adjacent normal tissues,and take samples of metastatic lymph node tissues of 45 patients with cervical lymph node metastasis.The expression of EGFR,ATG5 and p62 protein m PTC tissue,metastatic lymph node tissue and adjacent normal tissue were detected by unmunohistochemistry,and the relationship between EGFR,ATG5 and p62 protein expression and clinical charactenstics and survival of PTC patients was analyzed.Result The positive expression rates of EGFR and p62 protein in PTC tissues and metastatic lymph node tissues were higher than those in normal tissues adjacent to cancer,and the positive expression rates of ATG5 protein were lower than those in normal tissues adjacent to cancer,the differences were statistically significant(P<0.05).The positive expression rates of ATG5 protein in PTC tissues of PTC patients with different TNM stages and lymph node metastasis were statistically significant(P<0.05).The positive expression rates of p62 protein in PTC tissues of PTC patients with different differentiation degrees,TNM stages and lymph node metastasis were statistically significant(P<0.05).Spearman correlation analysis showed that the expression of ATG5 was negatively correlated with p62 in PTC and metastatic lymph node tissues(P<0.01).Among the 80 patients followed up for 3 years,22 died,and the 3-year survival rate was 72.50%(58/80).The 3-year survival rate of PTC patients with positive expression of p62 was65.52%,which was lower than that of patients with negative expression of 90.91%,the difference was statistically significant(P<0.05).The results of Cox risk proportional regression model showed that TNM staging,lymph node metastasis,EGFR positive expression,and p62 positive expression were independent risk factors for the prognosis of PTC patients(P<0.05),and positive expression of ATG5 was an independent protective factor for the prognosis of PTC patients(P<0.05).Conclusion EGFR and p62 are highly expressed in PTC tissues and lymph node metastatic tissues,while ATG5 is low,which can be used as independent prognostic factors for PTC patients.In addition,ATG5 and p62 are related to PTC biological behavior,and may be potential indicators for PTC diagno sis.