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目的探讨甲状腺乳头状癌、甲状腺低分化癌中E-cad、P53、BcI-2蛋白表达情况与它们的病理分级、转移、预后的关系。方法用HE和组织化学方法对23例甲状腺乳头状癌、17例甲状腺低分化癌进行诊断,用SP免疫组织化学方法检测E-cad、P53、BcI-2蛋白表达情况。结果甲状腺乳头状癌、甲状腺低分化癌中E-cad蛋白阳性表达率分别为78.3%(18/23)和23.5%(4/17),2组阳性表达率有显著性差异(呈负相关),P<0.05;P53蛋白阳性表达率分别为21.7%(5/23)和76.5%(13/17),2组阳性表达率有显著性差异(呈正相关),P<0.05;BcI-2蛋白阳性表达率分别为17.4%(4/23)和70.6%(12/17),2组阳性表达率有显著性差异(呈正相关),P<0.05。甲状腺乳头状癌组肺转移2例,甲状腺低分化癌组肺转移8例。原发灶E-cad蛋白均为失表达。结论E-cad、P53、BcI-2蛋白表达与甲状腺癌病理分级有显著相关性,E-cad与甲状腺癌远隔脏器(肺)转移明显相关。它们可作为判断预后、指导临床治疗的检测指标联合应用。
Objective To investigate the relationship between the expression of E-cad, P53 and BcI-2 in thyroid papillary carcinoma and poorly differentiated thyroid carcinoma and their pathological grade, metastasis and prognosis. Methods Twenty-three cases of thyroid papillary carcinoma and 17 cases of poorly differentiated thyroid carcinoma were diagnosed by HE and histochemical methods. The expressions of E-cad, P53 and BcI-2 were detected by SP immunohistochemistry. Results The positive rates of E-cad protein in thyroid papillary carcinoma and thyroid poorly differentiated carcinoma were 78.3% (18/23) and 23.5% (4/17), respectively. There was a significant difference (negative correlation) between the two groups (P <0.05). The positive rate of P53 protein expression was 21.7% (5/23) and 76.5% (13/17) respectively. There was a significant difference between the two groups The positive expression rates were 17.4% (4/23) and 70.6% (12/17) respectively. There was a significant difference between the two groups (P <0.05). 2 cases of thyroid papillary carcinoma metastasis and 8 cases of lung metastasis of poor thyroid carcinoma. E-cad protein in primary lesions were loss of expression. Conclusion The expressions of E-cad, P53 and BcI-2 are significantly correlated with the pathological grade of thyroid carcinoma. E-cad is significantly associated with the distant organs (lung) metastasis of thyroid carcinoma. They can be used as a prognostic indicator to guide the clinical treatment of joint detection of indicators.