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目的探讨基质金属蛋白酶(MMP)-2在甲状腺乳头状癌(PTC)复发或残留患者血清中的表达水平及其临床应用价值。方法采集2009年3月至2009年12月期间入住我科行手术治疗的68例甲状腺疾病患者的术前空腹血清和15位体检健康者的空腹血清。根据术后病理结果分为PTC伴淋巴结转移组(19例)、PTC复发或残留伴淋巴结转移组(17例)、PTC无淋巴结转移组(10例)、甲状腺良性疾病组(22例),体检健康者作为对照组(15位),采用ELISA法测定各组血清标本中MMP-2的表达水平,并分析各组MMP-2表达水平的差异。结果血清MMP-2表达水平在PTC复发或残留伴淋巴结转移组、PTC伴淋巴结转移组、PTC无淋巴结转移组、甲状腺良性疾病组及对照组中分别为(1 724.00±762.24)ng/ml、(1 329.16±776.59)ng/ml、(1 489.61±546.53)ng/ml、(1 264.87±817.27)ng/ml及(608.43±88.63)ng/ml,PTC复发或残留伴淋巴结转移组和PTC伴淋巴结转移组均分别明显高于甲状腺良性疾病组和对照组(P<0.05);PTC无淋巴结转移组仅明显高于对照组(P<0.05),而与甲状腺良性疾病组比较,差异无统计学意义(P>0.05)。甲状腺良性疾病组与对照组间比较差异也无统计学意义(P>0.05);3个恶性疾病组间MMP-2表达水平比较差异无统计学意义(P>0.05)。PTC伴淋巴结转移组、PTC复发或残留伴淋巴结转移组、PTC无淋巴结转移组、甲状腺良性疾病组及对照组的MMP-2表达阳性率分别为79%、76%、80%、41%及20%。3个恶性疾病组间阳性率比较差异均无统计学意义(P>0.05),但均分别明显高于甲状腺良性疾病组和对照组(P<0.01)。甲状腺良性疾病组的阳性率也明显高于对照组(P<0.01)。结论血清MMP-2的检测可以用于术前甲状腺包块性质判断的筛选指标;血清MMP-2水平检测不适用于判断PTC是否转移。
Objective To investigate the expression of matrix metalloproteinase-2 (MMP-2) in serum of patients with recurrent or residual thyroid papillary carcinoma (PTC) and its clinical value. Methods The fasting serum of preoperative fasting serum and 15 healthy volunteers were collected from 68 patients with thyroid disease undergoing surgical treatment in our department from March 2009 to December 2009. According to the postoperative pathological findings, there were 19 patients with PTC, 17 with PTC or residual lymph node metastasis, 10 with PTC without lymph node metastasis, 22 with benign thyroid disease, The healthy controls were selected as control group (15). The serum levels of MMP-2 in each group were determined by ELISA and the differences of MMP-2 expression in each group were analyzed. Results The serum level of MMP-2 was (1 724.00 ± 762.24) ng / ml in PTC recurrence or residual lymph node metastasis, PTC with lymph node metastasis, PTC non-lymph node metastasis, thyroid benign disease and control group, respectively 1 329.16 ± 776.59 ng / ml, (1 489.61 ± 546.53) ng / ml, (1 264.87 ± 817.27) ng / ml and (608.43 ± 88.63) ng / ml respectively. The patients with PTC recurrence or residual lymph node metastasis and PTC with lymph node Metastasis group were significantly higher than benign thyroid disease group and control group (P <0.05); PTC no lymph node metastasis group was significantly higher than the control group (P <0.05), but with thyroid benign disease group, the difference was not statistically significant (P> 0.05). There was no significant difference between thyroid benign disease group and control group (P> 0.05). There was no significant difference in MMP-2 expression among the three malignant disease groups (P> 0.05). The positive rates of MMP-2 in PTC with lymph node metastasis, PTC recurrence or residual lymph node metastasis, PTC without lymph node metastasis, thyroid benign disease group and control group were 79%, 76%, 80%, 41% and 20% respectively %. There was no significant difference in the positive rates between the three malignant groups (P> 0.05), but they were significantly higher than those in the benign thyroid disease group and the control group (P <0.01). The positive rate of thyroid benign disease group was also significantly higher than that of the control group (P <0.01). Conclusion The detection of serum MMP-2 can be used to judge the quality of preoperative thyroid mass. The detection of serum MMP-2 level is not suitable for judging the metastasis of PTC.