甲状腺乳头状癌CK19和COX-2表达的临床病理研究

Clinicopathologic study on expression of CK19 and COX-2 in papillary thyroid carcinoma

目的探讨CK19和COX-2表达与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)临床病理指标的关系。方法选取2017年5月至2020年12月手术切除的PTC标本,采用EliVisionTMplus免疫组化2步法检测CK19和COX-2在120例癌组织及30例癌旁甲状腺组织中的表达,分析PTC组织中的表达与患者年龄、TI-RADS分级、TNM分期、癌浸润、淋巴结转移5项临床病理指标的关系。运用SPSS 22.0软件分析,计数资料用例(%)表示,组间比较及相关性分析,P<0.05为差异有统计学意义。结果CK19和COX-2蛋白阳性染色均主要定位于细胞质。癌组织CK19和COX-2阳性率分别为87.50%(105/120)和72.50%(87/120),癌旁甲状腺组织分别为10.00%(3/30)和3.33%(1/30),差异有统计学意义(P均<0.05)。年龄<45岁组与≥45岁组,CK19阳性率分别为88.16%(67/76)、86.36%(38/44),COX-2阳性率分别为69.74%(53/76)、77.27%(34/44)。TI-RADS(4级+5级)组与6级组,CK19阳性率分别为85.26%(81/95)、96.00%(24/25),COX-2阳性率分别为69.47%(66/95)、84.00%(21/25),上述组间差异无统计学意义(P均>0.05)。TNM(T1期+T2期)组与T3期组,CK19阳性率分别为82.28%(65/79)、97.56%(40/41),COX-2阳性率分别为65.82%(52/79)、85.36%(35/41)。有癌浸润组与无浸润组,CK19阳性率分别为94.44%(68/72)、77.08%(37/48),COX-2阳性率分别为83.33%(60/72)、56.25%(27/48)。有淋巴结转移组与无转移组,CK19阳性率分别为95.59%(65/68)、76.92%(40/52),COX-2阳性率分别为83.82%(57/68)、57.69%(30/52),通过组间比较差异有统计学意义(P均<0.05)。120例CK19和COX-2共阳率为70.83%(85/120),共阴率为10.83%(13/120),通过列联系数进行相关性分析,2者表达呈正相关(r=0.45,P<0.05)。结论CK19和COX-2表达阳性率与患者年龄和TI-RADS分级无关,与TNM分期、癌浸润和淋巴结转移密切相关,2者表达上调均预示癌组织分期高,浸润性强,易发生淋巴结转移。

Objective To investigate CK19 and COX-2 expression in papillary thyroid carcinoma(PTC)and their relationship with clinicopathologic parameters.Methods Retrospective study of 120 consecutive patients with PTC who underwent resection from May.2017 to Dec.2020 was conducted.The expression of CK19 and COX-2 in 120 pieces of primary PTC tissue and 30 pieces of adjacent carcinoma tissue were detected by EliVisionTM plus two-step immunohistochemical method.The relationship between the expression of CK19 and COX-2 and the clinicopathologic parameters including patient age,TI-RADS classification,TNM staging,carcinomatous infiltration,lymph node metastasis was studied.The analysis was performed using SPSS 22.0 software.The numerical data were presented as numbers and percentages,and chi-test(χ^(2) test)and Pearson’s correlation were used to analyze the difference and association between two groups.P<0.05 was considered statistically significant.Results The positive immunostaining of CK19 and COX-2 were mainly localized in the cytoplasm.The positive rates of CK19 and COX-2 were 87.50%(105/120)and 72.50%(87/120)in cancer tissues and 10.00%(3/30)and 3.33%(1/30)in paracancerous tissues,respectively,with statistically significant differences(both P<0.05 byχ^(2) test).In the groups with patients aged<45 years versus≥45 years,the CK19 positive rates were 88.16%(67/76)and 86.36%(38/44),and the COX-2 positive rates were 69.74%(53/76)and 77.27%(34/44),respectively.In the groups of TI-RADS(grade 4 and 5)versus grade 6,the CK19 positive rates were 85.26%(81/95)and 96.00%(24/25),and the COX-2 positive rates were 69.47%(66/95)and 84.00%(21/25),respectively,with no statistically significant differences between the two groups(both P>0.05).In the groups of TNM(stage T1 and T2)versus stage T3,the CK19 positive rates were 82.28%(65/79)and 97.56%(40/41),and the COX-2 positive rates were 65.82%(52/79)and 85.36%(35/41),respectively.In the groups with versus without cancer infiltration,the CK19 positive rates were 94.44%(68/72)and 77.08%(37/48),and the COX-2 positive rates were 83.33%(60/72)and 56.25%(27/48),respectively.In the groups with versus without lymph node metastasis,the CK19 positive rates were 95.59%(65/68)and 76.92%(40/52),and the COX-2 positive rates were 83.82%(57/68)and 57.69%(30/52),respectively,and the differences between the above groups were statistically significant(all P<0.05 byχ^(2) test).The co-positive and co-negative expression rates of CK19 and COX-2 in 120 patients were 70.83%(85/120)and 10.83%(13/120),respectively,with a positive correlation(r=0.45,P<0.05 by Pearson’s correlation).Conclusions The positive rates of CK19 and COX-2 expressions are not related to patient’s age or TI-RADS classification,but closely related to TNM stage,cancer invasion and lymph node metastasis.The up-regulation of both CK19 and COX-2 expressions predicts higher tumor stage,more aggressive invasion and more prone to lymph node metastasis.