血清紧密连接蛋白1与甲状腺乳头状癌相关性研究

Relationship between serum claudin-1 level and papillary thyroid carcinoma

目的分析甲状腺结节患者血清紧密连接蛋白1(claudin-1,Cla-1)水平与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)患病风险的相关性。方法回顾性分析345例甲状腺结节患者的临床资料,根据病理结果分为PTC组和良性甲状腺结节(benign thyroid nodule,BTN)组,统计分析组间血清Cla-1水平的差异及其与PTC患病风险的相关性。结果在PTC(n=225)和BTN(n=120)中血清Cla-1水平中位值为14.03(10.30,20.40)ng/mL。Wilcoxon符号秩检验显示血清Cla-1水平在PTC和BTN中的中位值[17.90(14.00,22.93)ng/mL比9.40(8.15,11.20)ng/mL]差异具有统计学意义(P<0.01)。随着血清Cla-1水平的升高,甲状腺结节中PTC患病率逐渐增加。受试者工作特征(ROC)曲线法分析,诊断PTC最佳的临界值为13.02 ng/mL,灵敏度为81.8%,特异度为89.2%,ROC曲线下面积(AUC)最大(AUC=0.944,P<0.01,95%CI 0.922~0.965)。Logistic回归分析发现血清Cla-1水平升高将增加PTC的风险,具有统计学意义(OR=4.334,95%CI 1.662~11.303,P=0.003)。血清Cla-1水平与性别、年龄、PTC累及部位、癌灶数目与直径、甲状腺外侵犯、淋巴结转移、TNM分期及合并桥本甲状腺炎组间比较差异具有统计学意义(P<0.01)。结论血清Cla-1水平可能是预测PTC风险的指标之一,并与体内PTC肿瘤细胞总量有关,而与肿瘤侵袭性行为无关。

Objective To analyze the correlation between serum claudin-1(Cla-1)level and the risk of papillary thyroid carcinoma(PTC)in patients with thyroid nodules.Methods The clinical data of 345 patients with thyroid nodules were retrospectively analyzed.According to the pathological results,they were divided into PTC group and benign thyroid nodule(BTN)group.The difference of serum Cla-1 level between 2 groups and its correlation with the risk of PTC were analyzed.Results In groups of PTC(n=225)and BTN(n=120),the median value of serum Cla-1 level was 14.03(10.30,20.40)ng/mL.The differences in the median value[17.90(14.00,22.93)ng/mL vs 9.40(8.15,11.20)ng/mL]of serum Cla-1 level in the PTC and BTN were statistically significant by Wilcoxon signed-rank test.The prevalence of PTC in thyroid nodules increased gradually with increasing of serum Cla-1 level.Receiver operated characteristic curve analysis showed that the best diagnostic cut-off value of the PTC was 13.02 ng/ml of which the sensitivity was 81.8%,the specificity was 89.2%,and the area under curve(AUC)was the largest(AUC=0.944,P<0.01,95%CI 0.922-0.965).Logistic regression analysis showed that elevated serum Cla-1 level increased the risk of PTC,and it was statistically significant(OR=4.334,95%CI 1.662-11.303,P=0.003).There was a significant correlation among the serum Cla-1 level and gender,age,location of involvement,number and diameter of cancer nodules,extracapsular invasion of thyroid,lymph node metastasis,tumor stage and combined with Hashimoto′s thyroiditis(P<0.01).Conclusion The serum level of Cla-1 may be one of risk factors to predict PTC,and it is related to the total amount of PTC tumor cells in vivo,but it was not related to the aggressive behavior of tumor.