甲状腺癌组织中CD147及survivin表达与术后淋巴结转移的相关性

Correlations of the levels of CD147 and survivin with postoperative lymph node metastasis in thyroid cancer

目的观察甲状腺癌组织中CD147、生存素survivin表达变化,探讨CD147、survivin与甲状腺癌手术治疗后淋巴结转移的关系。方法97例甲状腺癌患者手术切除的癌组织为甲状腺癌组、切除的癌旁正常组织为癌旁组,80例结节性甲状腺肿患者手术切除的甲状腺组织为结节性甲状腺肿组。3组采用免疫组织化学法检测CD147、survivin阳性表达率,并进行比较。对甲状腺癌患者进行随访,其中发生淋巴结转移者32例为转移组,未发生淋巴结转移者65例为未转移组,比较2组临床资料及CD147、survivin、caspase-3、基质金属蛋白酶-2(matrix matalloproteinase-2,MMP-2)阳性表达率;多因素logistic回归分析甲状腺癌患者术后发生淋巴结转移的影响因素;绘制ROC曲线评估CD147、survivin阳性表达预测甲状腺癌患者术后发生淋巴结转移的价值。结果CD147、survivin阳性表达率在甲状腺癌组(76.29%、83.51%)、结节性甲状腺肿组(33.75%、40.00%)高于癌旁组(9.28%、14.43%),甲状腺癌组高于结节性甲状腺肿组(P<0.05)。转移组CD147、survivin、caspase-3、MMP-2阳性表达率(71.88%、68.75%、43.75%、46.88%)高于未转移组(38.46%、30.77%、23.08%、24.62%)(P<0.05),年龄、性别比例、体质量指数、术前临床分期与未转移组比较差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,caspase-3阳性表达(OR=2.593,95%CI:1.048~6.415,P=0.039)、MMP-2阳性表达(OR=2.702,95%CI:1.104~6.611,P=0.029)、CD147阳性表达(OR=4.089,95%CI:1.632~10.244,P=0.003)、survivin阳性表达(OR=3.850,95%CI:1.523~9.735,P=0.004)是甲状腺癌患者术后发生淋巴结转移的危险因素。ROC曲线分析结果显示,CD147、survivin阳性表达预测甲状腺癌患者术后发生淋巴结转移的AUC分别为0.801(95%CI:0.702~0.903,P<0.001)、0.812(95%CI:0.708~0.910,P<0.001),灵敏度分别为0.932、0.920,特异度分别为0.765、0.709。结论甲状腺癌患者术后发生淋巴结转移与组织中CD147、survivin、caspase-3、MMP-2阳性表达有关;CD147、survivin阳性表达在预测甲状腺癌患者术后淋巴结转移中有较高价值。

Objective To observe the changes of CD147 and survivin in thyroid cancer tissue,and to analyze the correlations of CD147 and survivin with postoperative lymph node metastasis after thyroid cancer resection.Methods The positive rates of CD147 and survivin were detected by immunohistochemistry and were compared among the resected thyroid cancer tissue(thyroid cancer group)and adjacent normal tissue(adjacent normal group)from 97 patients with thyroid cancer as well as in the resected thyroid tissue from 80 patients with nodular goiter(nodular goiter group).All patients were followed up,showing lymph node metastasis in 32 patients(metastasis group)and no lymph node metastasis in 65 patients(non-metastasis group).The clinical data and the positive rates of CD147,survivin,caspase-3 and matrix matalloproteinase-2(MMP-2)were compared between metastasis group and non-metastasis group.Multivariate logistic regression analysis was used to assess the influencing factors of postoperative lymph node metastasis in patients with thyroid cancer.ROC was drawn to evaluate the value of the positive expressions of CD147 and survivin to the prediction of postoperative lymph node metastasis in patients with thyroid cancer.Results The positive rates of CD147 and survivin were higher in thyroid cancer group(76.29%,83.51%)and nodular goiter group(33.75%,40.00%)than those in adjacent normal group(9.28%,14.43%),and higher in thyroid cancer group than those in nodular goiter group(P<0.05).The positive rates of CD147,survivin,caspase-3 and MMP-2 were higher in metastasis group(71.88%,68.75%,43.75%,46.88%)than those in non-metastasis group(38.46%,30.77%,23.08%,24.62%)(P<0.05),while the age,sex ratio,body mass index and preoperative clinical stage showed no significant differences between two groups(P>0.05).Multivariate logistic regression analysis showed that the positive expressions of caspase-3(OR=2.593,95%CI:1.048-6.415,P=0.039),MMP-2(OR=2.702,95%CI:1.104-6.611,P=0.029),CD147(OR=4.089,95%CI:1.632-10.244,P=0.003)and survivin(OR=3.850,95%CI:1.523-9.735,P=0.004)were the risk factors of postoperative lymph node metastasis in patients with thyroid cancer.ROC analysis showed that the AUCs of positive CD147 and survivin for predicting postoperative lymph node metastasis were 0.801(95%CI:0.702-0.903,P<0.001)and 0.812(95%CI:0.708-0.910,P<0.001),the sensitivities were 0.932 and0.920,and the specificities were 0.765 and 0.709,respectively.Conclusion Lymph node metastasis after surgery might be correlated with the positive expressions of CD147,survivin,caspase-3 and MMP-2.The positive expressions of CD147 and survivin have high values to the prediction of postoperative lymph node metastasis in patients with thyroid cancer.