甲状腺乳头状癌组织的CCND1、LGALS3表达及与淋巴结转移的关系

Expressions of CCND1 and LGALS3 in papillary thyroid carcinoma tissues and their relationships with lymph node metastasis

目的分析细胞周期蛋白D1(CCND1)、半乳糖凝聚素3(LGALS3)在甲状腺乳头状癌(PTC)组织中的表达及与淋巴结转移的关系。方法收集2020年6月至2021年6月在本院接受手术治疗的90例PTC患者临床资料,根据术后病理检查情况,将发生淋巴结转移患者的临床资料纳入转移组,将未发生淋巴结转移患者的临床资料纳入未转移组。对比两组的CCND1、LGALS3表达情况和基线资料。采用Spearman分析CCND1、LGALS3表达与PTC患者淋巴结转移的相关性;采用二元logistic回归分析CCND1、LGALS3表达与PTC患者淋巴结转移发生的关系;采用Kappa分析CCND1、LGALS3诊断PTC患者淋巴结转移与病理结果的一致性。结果90例PTC组织中CCND1阳性表达46例、阴性表达44例,而LGALS3阳性表达44例、阴性表达46例,且两者阳性细胞面积呈正相关(r=0.307,P=0.003);发生淋巴结转移51例(56.67%),未发生39例(43.33%)。转移组肿瘤病灶数量为多灶、CCND1或LGALS3表达为阳性者的比例分别为72.55%(37/51)、80.39%(41/51)和70.59%(36/51),高于未转移组的46.15%(18/39)、12.82%(5/39)和20.51%(8/39),差异有统计学意义(P<0.05)。CCND1、LGALS3阳性细胞面积与淋巴结转移呈正相关(r=0.594、0.463,P<0.001)。肿瘤病灶为多灶与CCND1、LGALS3阳性表达是PTC患者发生淋巴结转移的危险因素(OR=1.815、1.386和3.457,P<0.05);CCND1诊断PTC患者淋巴结转移的敏感度、特异度、准确度分别为92.16%(47/51)、76.92%(30/39)、85.56%(77/90),LGALS3诊断的分别为88.24%(45/51)、79.49%(31/39)、84.44%(76/90),联合检测诊断的分别为98.04%(50/51)、76.92%(30/39)、88.89%(80/90),CCND1、LGALS3及联合检测与病理检查结果的一致性(Kappa值)分别为0.701、0.681、0.768。结论PTC患者CCND1、LGALS3表达情况与淋巴结转移的发生呈正相关,两者阳性表达是淋巴结转移发生的危险因素,且联合可诊断PTC患者淋巴结转移发生情况。

Objective To analyze the expressions of cyclin D1(CCND1)and galectin 3(LGALS3)in papillary thyroid carcinoma(PTC)tissues and their relationships with lymph node metastasis.Methods Clinical data of 90 patients with PTC who received surgical treatment in our hospital from June 2020 to June 2021 were collected.According to the postoperative pathological examination of patients,clinical data of patients with lymph node metastasis were included in the metastasis group,and clinical data of patients without lymph node metastasis were included in the non-metastasis group.Expressions of CCND1 and LGALS3 and baseline data in both groups were compared.Correlation between CCND1 and LGALS3 expression and the lymph node metastasis in PTC patients was analyzed by using the Spearman correlation test.Relationship between the CCND1 and LGALS3 expression and the occurrence of lymph node metastasis in PTC patients was analyzed by binary logistic regression.Kappa was used to analyze the consistency between the pathological results and the diagnosis of lymph node metastasis in PTC patients by using CCND1 and LGALS3.Results Among 90 PTC tissues,46 were positive and 44 were negative for CCND1 expression,while 44 were positive and 46 were negative for LGALS3 expression.The positive cell area of the two indices was positively correlated(r=0.307,P=0.003).Fifty-one cases(56.67%)had lymph node metastasis,while 39 cases(43.33%)did not occur.The proportion of patients with multiple tumor lesions and positive expression of CCND1 or LGALS3 in the metastatic group was 72.55%(37/51),80.39%(41/51)and 70.59%(36/51),higher than 46.15%(18/39),12.82%(5/39)and 20.51%(8/39)in the non-metastatic group with statistically significant differences(P<0.05).The presence of multiple tumor lesions and positive expression of CCND1 or LGALS3 were risk factors for lymph node metastasis in PTC patients(OR=1.815,1.386 and 3.457,P<0.05).The sensitivity,specificity and accuracy of CCND1 in diagnosis of lymph node metastasis in PTC patients were 92.16%(47/51),76.92%(30/39)and 85.56%(77/90),while the sensitivity,specificity and accuracy of LGALS3 were 88.24%(45/51),79.49%(31/39)and 84.44%(76/90).The sensitivity,specificity and accuracy of the combined detection were 98.04%(50/51),76.92%(30/39)and 88.89%(80/90),respectively.The agreements(Kappa values)of CCND1,LGALS3 and the combined detection with pathological examination were 0.701,0.681 and 0.768,respectively.Conclusion Expressions of CCND1 and LGALS3 in PTC patients are positively correlated with the occurrence of lymph node metastasis,and their positive expressions are risk factors for the occurrence of lymph node metastasis.The combination can be used to diagnose the occurrence of lymph node metastasis in PTC patients.