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目的研究甲状腺髓样癌患者降钙素及其基因相关肽的变化规律,指导临床治疗方案的选择和患者预后的判断。方法回顾性研究包括对58例甲状腺髓样癌病例血清中降钙素的分析及应用免疫组织化学方法观察相应标本中降钙素及其基因相关肽的表达情况;对新人组30例病例进行放射免疫学测定。结果(1)术后1个月降钙素水平正常与升高的患者之间,肿瘤复发存在显著性差异(P<0.01)。(2)约98%的患者肿瘤标本降钙素染色呈阳性,而降钙素基因相关肽的阳性率为87.8%。(3)部分术前降钙素水平正常的患者降钙素基因相关肽水平升高。(4)术后1周左右降钙素下降至一稳定水平。结论降钙素可以作为指导甲状腺髓样癌诊断和治疗的重要指标,检测降钙素基因相关肽有助于部分降钙素阴性的甲状腺髓样癌患者术前诊断。
Objective To study the changes of calcitonin and its gene related peptide in patients with medullary thyroid carcinoma and to guide the choice of clinical treatment plan and the prognosis of patients. Methods The retrospective study included 58 cases of medullary thyroid carcinoma serum calcitonin analysis and application of immunohistochemical methods to observe the corresponding specimens of calcitonin and its gene-related peptide expression; new group of 30 cases of radiation Immunological assay. Results (1) There was a significant difference in tumor recurrence between patients with normal and elevated calcitonin at 1 month after operation (P <0.01). (2) About 98% of the patients had positive calcitonin staining, while the positive rate of calcitonin gene-related peptide was 87.8%. (3) elevated levels of calcitonin gene-related peptide in some patients with normal preoperative calcitonin levels. (4) calcitonin decreased to a stable level about 1 week after operation. Conclusion Calcitonin can be used as an important index in the diagnosis and treatment of medullary thyroid carcinoma. Detection of calcitonin gene-related peptide may be helpful for the preoperative diagnosis of some calcitonin-negative patients with medullary thyroid carcinoma.