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目的研究雌激素受体α36(ERα36)、鸟嘌呤核苷酸交换因子(GNEF)-Vav3和存活素在人甲状腺乳头状癌(PTC)中的表达及意义。方法选取112例癌旁正常组织为对照组,124例甲状腺乳头状癌组织为试验组,用免疫组织化学SP法检测ERα36、GNEF-Vav3和存活素的表达情况,并分析其与临床病理指标的关系和三者表达的相关性。结果在124例PTC组织中,ERα36、GNEF-Vav3和存活素的阳性表达率分别为55.6%(69/124例)、56.5%(70/124例)和57.3%(71/124例),三者在PTC中的表达显著高于正常组织,差异有统计学意义(P<0.001)。在有颈部淋巴结转移的PTC组织中,ERα36、GNEF-Vav3和存活素的阳性表达率分别为80.9%(55/68例)、77.9%(53/68例)和82.4%(56/68例),明显高于无淋巴结转移组织的25.0%(14/56例)、30.4%(17/56例)和26.8%(15/56例),差异有统计学意义(P<0.001)。在TNMⅢ-Ⅳ期的PTC组织中,ERα36、GNEF-Vav3和存活素的阳性表达率分别为81.7%(49/60例)、75.0%(45/60例)和78.3%(47/60例),明显高于Ⅰ-Ⅱ期的31.3%(20/64例)、39.1%(25/64例)和37.5%(24/64例),差异有统计学意义(P<0.001)。经Spearman等级相关分析,在124例PTC中,ERα36为78.3%(54/69例,高表达)与GNEF-Vav3为77.1%(54/70例)的阳性表达率呈显著正相关(P<0.001);ERα36为72.5%(50/69例,高表达)与存活素为70.4%(50/71例)的阳性表达率呈显著正相关(P<0.001);GNEF-Vav3为68.6%(48/70例)与存活素67.6%(48/71例)的阳性表达率呈显著正相关(P<0.01)。ERα36/GNEF-Vav3、ERα36/存活素和GNEF-Vav3/存活素的这三种情况下的两种蛋白同时表达率分别为81.5%,80.0%,83.3%,这与其中仅有一种蛋白表达的48.4%,57.5%,60.0%比较,与颈部淋巴结转移的相关性更为显著,差异有统计学意义(均P<0.05)。此外,ERα36、GNEF-Vav3和存活素的这三种蛋白联合表达率为88.9%,这与只表达一种或两种蛋白的40.9%比较,与颈部淋巴结转移的相关性更为显著,差异有统计学意义(P<0.001)。结论 ERα36、GNEF-Vav3和存活素在PTC中的表达存在协同作用,并可作为监测PTC颈部淋巴结转移的指标。
Objective To study the expression of estrogen receptor α36 (ERα36), guanine nucleotide exchange factor (GNEF) -Vav3 and survivin in human thyroid papillary carcinoma (PTC). Methods 112 cases of adjacent normal tissues were selected as the control group, 124 cases of thyroid papillary carcinoma tissue as experimental group, the expression of ERα36, GNEF-Vav3 and survivin were detected by immunohistochemical SP method, and analyzed with the clinicopathological parameters Relationships and the relevance of the three expressions. Results The positive rates of ERα36, GNEF-Vav3 and survivin in 124 PTC tissues were 55.6% (69/124), 56.5% (70/124) and 57.3% (71/124), respectively The expression of PTC in PTC was significantly higher than that in normal tissue (P <0.001). The positive rates of ERα36, GNEF-Vav3 and survivin in PTC tissues with cervical lymph node metastasis were 80.9% (55/68), 77.9% (53/68) and 82.4% (56/68) respectively ) Was significantly higher than that in non-lymph node metastases (25.0%, 14/56 cases), 30.4% (17/56 cases) and 26.8% (15/56 cases). The difference was statistically significant (P <0.001). The positive rates of ERα36, GNEF-Vav3 and survivin in TNMⅢ-Ⅳ PTC were 81.7% (49/60), 75.0% (45/60) and 78.3% (47/60) respectively, , Which was significantly higher than 31.3% (20/64 cases), 39.1% (25/64 cases) and 37.5% (24/64 cases) in stage Ⅰ-Ⅱ, the difference was statistically significant (P <0.001). Spearman rank correlation analysis showed that there was a significant positive correlation between the expression of ERα36 in 78.3% (54/69 cases, high expression) and the positive expression rate of GNEF-Vav3 in 77.1% (54/70 cases) (P <0.001 ). The positive expression rates of ERα36 in 72.5% (50/69 cases with high expression) and survivin in 70.4% (50/71 cases) were positively correlated (P <0.001). The GNEF-Vav3 was 68.6% 70 cases) and survivin 67.6% (48/71 cases) were positively correlated (P <0.01). The simultaneous expression rates of ERα36 / GNEF-Vav3, ERα36 / Survivin and GNEF-Vav3 / Survivin were 81.5%, 80.0% and 83.3% 48.4%, 57.5% and 60.0% respectively. There was a significant difference between cervical lymph node metastasis and cervical lymph node metastasis (all P <0.05). In addition, the combined expression rate of these three proteins of ERα36, GNEF-Vav3 and survivin was 88.9%, which was significantly higher than that of only expressing one or two proteins, which was significantly associated with cervical lymph node metastasis. The difference There was statistical significance (P <0.001). Conclusion The expression of ERα36, GNEF-Vav3 and survivin in PTC is synergistic and can be used as an indicator to monitor the cervical lymph node metastasis of PTC.