TK1、Ki67蛋白在分化型甲状腺癌组织中的表达及预后价值研究

The expression and prognostic value of TK1 and Ki67 proteins in differentiated thyroid carcinoma

目的探讨癌组织中胸苷激酶1(TK1)、细胞增殖抗原67(Ki67)蛋白表达与经乳晕入路腔镜辅助甲状腺切除术治疗的分化型甲状腺癌(DTC)患者预后的关系。方法采用病例对照研究,将2012年6月至2016年6月40例接受经乳晕入路腔镜切除术治疗预后不良的DTC患者,纳入预后不良组;将同期40例接受经乳晕入路腔镜切除术治疗预后良好的DTC患者,纳入预后良好组。所有患者完成5年随访。用SPSS 23.0软件进行数据处理,计数资料以[例(%)]表示,用χ^(2)检验;等级资料用秩和检验;全部计量资料均经Shapiro-Wilk正态性检验,符合正态分布用x±s表示,组间比较采用独立样本t检验;偏态分布的计量资料用[M(P25,P75)]表示,组间比较用Mann-Whitney U检验;绘制受试者工作曲线(ROC)分析TK1、Ki67蛋白表达与DTC患者经乳晕入路腔镜切除术后预后的关系。以P<0.05为差异有统计学意义。结果DTC癌组织中TK1、Ki67蛋白阳性表达率(66.25%、71.25%)高于癌旁正常组织(21.25%、23.75%)(P<0.05);预后不良组患者甲状腺球蛋白(Tg)、促甲状腺激素(TSH)水平高于预后良好组,TK1、Ki67蛋白阳性表达率高于预后良好组(P<0.05);ROC曲线显示,TK1、Ki67蛋白表达预测经乳晕入路腔镜切除预后不良价值的AUC分别为0.825(95%CI: 0.728-0.922)、0.863(95%CI: 0.775-0.950),有一定预测价值。结论DTC患者预后与癌组织中TK1、Ki67蛋白表达有关。

Objective To investigate the relationship between the expression of thymidine kinase 1(TK1) and cell proliferation antigen 67(Ki67) protein in cancer tissues and the prognosis of patients with differentiated thyroid carcinoma (DTC) treated by endoscopic assisted thyroidectomy via areola approach.Methods In a case control study, 40 DTC patients with poor prognosis who received endoscopic resection via areola from June 2012 to June 2016 were included in the poor prognosis group. At the same time, 40 patients with DTC with good prognosis who received endoscopic resection via areola approach were included in the good prognosis group. All patients were followed up for 5 years. SPSS 23.0 software was used for data processing. The enumeration data were expressed as [cases (%)], and χ^(2) test was used. Rank sum test was used for grade data;all measurement data were tested by Shapiro-Wilk normality test, and the normal distribution was expressed as x±s. Independent sample t test was used for comparison between groups. Measurement data with skewed distribution were expressed as [M(P25, P75)], and Mann-Whitney U test was used for comparison between groups. The receiver operating curve (ROC) was drawn to analyze the relationship between the expression of TK1 and Ki67 protein and the prognosis of DTC patients after endoscopic resection via areola approach. P<0.05 was considered statistically significant.Results The positive expression rate of TK1 and Ki67 protein in DTC cancerous tissues (66.25%, 71.25%) was higher than that in adjacent tissues (21.25%, 23.75%) (P<0.05);the levels of thyroglobulin (Tg) and thyroid stimulating hormone (TSH) in patients with poor prognosis were higher than those in patients with good prognosis, and the positive expression rates of TK1 and Ki67 protein were higher than those in patients with good prognosis (P<0.05). The ROC curve was drawn. The results showed that the AUC of TK1 and Ki67 protein expression predicting the poor prognosis of endoscopic resection via areola approach were 0.825 (95% CI: 0.728-0.922) and 0.863 (95% CI: 0.775-0.950), respectively, which had certain predictive value.Conclusion The prognosis of DTC patients may be related to the expression of TK1 and Ki67 proteins in cancer tissues, and TK1 and Ki67 proteins can be used as prognostic indicators of DTC patients.