甲状腺乳头状癌中紧密连接蛋白-1的表达与临床意义

Expressions and clinical significance of claudin-1 in papillary thyroid carcinoma

目的探讨甲状腺乳头状癌(PTC)组织中紧密连接蛋白-1(Claudin-1)的表达与临床意义。方法收集2017年1月至2019年10月平顶山市第一人民医院和中国人民解放军联勤保障部队第九八九医院平顶山医疗区甲状腺手术存档标本共计271例。采用免疫组化EliVision两步法检测116例PTC、145例甲状腺良性病变(BTL)和10例甲状腺滤泡癌中Claudin-1的表达状况,并分析其表达与PTC病人临床病理特征之间的关系。结果在116例PTC中Claudin-1高表达率为97.4%;在145例BTL中高表达率为11.7%;在10例滤泡癌中高表达率为10.0%。此外,Claudin-1在16例有PTC转移的淋巴结中全部高表达(100%),并且与甲状腺内原发癌灶的表达一致;在40例肿瘤周围的正常甲状腺组织中全部不表达。Claudin-1表达在PTC与BTL(χ^(2)=189.282)、PTC与滤泡癌的比较(χ^(2)=71.810),均差异有统计学意义(均P<0.001)。Claudin-1的表达与病人性别、年龄、癌结节长径与数目、淋巴结转移及TNM分期无关(P>0.05)。Claudin-1诊断PTC的灵敏度为97.4%,Claudin-1在PTC分别与BTL和滤泡癌的鉴别诊断中的特异度为88.3%和90.0%。结论Claudin-1有助于PTC分别与BTL和滤泡癌的鉴别诊断;Claudin-1的高表达可能是PTC肿瘤细胞黏附性强的关键因素。

Objective To investigate the expression and clinical significance of claudin-1 in papillary thyroid carcinoma(PTC).Methods From January 2017 to October 2019,271 archived thyroid surgery specimens in Pingdingshan First People's Hospital and Pingdingshan Medical District of the 989 Hospital of the joint logistics support force of the Chinese PLA were collected.The expressions of claudin-1 in 116 cases of PTC,145 cases of benign thyroid lesions(BTL)and 10 cases of follicular thyroid carcinoma were detected by immunohistochemical MaxVision method,and the relationship between them and the clinical pathological characteristics was analyzed.Results The high expression rate of claudin-1 in 116 cases of PTC was 97.4%.The high expression rate of claudin-1 in 116 cases of BTL was 11.7%.The high expression rate of claudin-1 in 10 cases of follicular thyroid carcinoma was 10.0%.In addition,claudin-1 was highly expressed in all 16 lymph nodes with PTC metastasis,which was consistent with the expression of PTC in thyroid.No expression of claudin-1 was found in the normal thyroid tissues around 40 cases of tumors.The expression of claudin-1 in PTC and BTL was significantly different(χ^(2)=189.282,P<0.001),the expression of claudin-1 in PTC and follicular carcinoma was still statistically significant(χ^(2)=71.810,P<0.001).The expression of claudin-1 was not related with age,gender,number and diameter of tumor nodules,lymph node metastasis,and TNM staging(P>0.05).The sensitivity of claudin-1 in the diagnosis of PTC was 97.4%.The specificity of claudin-1 was 88.3%in the differential diagnosis of PTC and BTL,and 90.0%in the differential diagnosis of PTC follicular carcinoma.Conclusion Claudin-1 is helpful for the differential diagnosis of PTC and BTL,as well as PTC and follicular carcinoma.The overexpression of claudin-1 may be the key factor of strong adhesion of PTC tumor cells.