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BACKGROUND:H2AX serves as one varient of histone H2A and helps maintain genomic stability.DNA double-strand break (DSB) plays in a role in H2AX phosphorylation (γH2AX).Increasing evidences illustrated γH2AX was related to thyroid diseases.However,the differential expression of γH2AX in nodular goiter and papillary thyroid carcinoma (PTC) was unknown.Here,we investigated the γH2AX expression in PTC and nodular goiter,as well as the significance of the aberrant expression.METHODS:Immunohistochemistry staining was used to detect γH2AX expression level in 140 specimens with thyroid diseases (30 cases of PTC,30 cases of nodular goiter and 80 cases of PTC coexisted with nodular goiter).The possible relationships between patients clinicpathological characteristics and γH2AX expression were analyzed.RESULTS:In the group of nodular goiter,10.0% (3/30) of normal adjacent specimens and 20.0% (6/3 0) of nodular goiter tissues showed high γH2AX expression (P>0.05).In the group of PTC,0.0% (0/30) of normal adjacent tissues and 70.0% (21/30) of PTC tissues exhibited high γH2AX expression (P<0.05).In the group of PTC coexisted with nodular goiter,8.8% (7/80) of normal adjacent tissues,95.0% (76/80) of PTC specimens and 12.5% (10/80) of nodular goiter component showed high expression of γH2AX (P<0.05).85.5% (65/76) of PTC patients with lymph node metastasis showed high yH2AX expression level,which was less than that in patients without lymph node metastasis (34/34,100.0%) (P=0.003).76.2% (16/21) of stage Ⅳ patients showed high γH2AX expression and the proportion was lower than that in stage Ⅱ -Ⅲ patients (83/89,93.3%) (P=0.034).There was no statistically significant correlation between γH2AX expression level and other clinicopathological features,including gender,age,tumor size,capsular invasion,tumor focus number,T status and distant metastasis.CONCLUSIONS:γH2AX expression in PTC was higher than that in nodular goiter and normal adjacent tissues,while there was no statistically significant difference between γH2AX expression in nodular goiter and normal adjacent tissues.γH2AX expression had a negative correlation with TNM stage and lymph node metastasis.γH2AX might inhibit lymph node metastasis and play a more critical role in early-stage PTC rather than late-stage PTC.