Glil蛋白和血管内皮生长因子-C在甲状腺乳头状癌中的表达及其与颈部淋巴结转移的关系  

Expression of Glil protein and vascular endothelial growth factor-C in papillary thyroid carcinoma and their relationship with cervical lymph node metastasis

作　　者：石东亮[1] 赵苏远[1] 陈倩倩[2] 李清怀[1] 

机构地区：[1]河北医科大学第二医院甲状腺外科,石家庄050000 [2]河北省沧州市中心医院护理部

出　　处：《中国医师进修杂志》2013年第20期30-34,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：【摘要】目的研究Glil蛋白和血管内皮生长因子（VEGF）-C在甲状腺乳头状癌中的表达及其与甲状腺乳头状癌临床病理特征和颈部淋巴结转移的关系。方法采用免疫组织化学EnVision法测定67例甲状腺乳头状癌患者及32例结节性甲状腺肿患者病理组织标本中Glil蛋白和VEGF．C的表达，同时分别用单克隆抗体CD。和D2—40标记各病理标本中的新生微血管和微淋巴管，计算肿瘤的微血管密度（MVD）和微淋巴管密度（MLVD），分析Glil蛋白阳性表达与MVD的关系、VEGF—C阳性表达与MLVD的关系及其与颈部淋巴结转移的关系。结果甲状腺乳头状癌组织中Glil蛋白阳性率、VEGF．C阳性率、MVD、MLVD分别为67．16％（45，67）、70．15％（47／67）、23．14±2．06、13．36±1．32，结节性甲状腺肿组织中分别为43．75％（14／32）、31．25％（10／32）、2．14±0．31、3．53±0．65，两者比较差异有统计学意义（P〈0．05）。Glil蛋白阳性表达与患者的年龄、肿瘤大小有相关性（P〈0．05），而VEGF．C阳性表达与患者的年龄、肿瘤大小无相关性（P〉0．05）。Glil蛋白和VEGF—C在TNM分期Ⅲ～Ⅳ期甲状腺乳头状癌患者的阳性表达率显著高于TNM分期Ⅰ～Ⅱ期患者，Glil蛋白和VEGF．C在有颈部淋巴结转移患者中的阳性表达率显著高于无颈部淋巴结转移患者，有颈部淋巴结转移患者的MVD与MLVD均显著高于无颈部淋巴结转移患者，差异均有统计学意义（P〈0．01或〈0．05）。甲状腺乳头状癌组织中Glil蛋白阳性表达与MVD呈正相关（r=0．784，P〈0．01），VEGF—C阳性表达与MLVD呈正相关（r=0．529，P〈0．01），Glil蛋白与VEGF．C阳性表达也呈正相关（r=0．586，P〈0．01）。结论Glil蛋白通过Hedgehog信号通路的异常激活得以表达，可能参与了新生微血管的生成；VEGF—C通过介导和启动MAPK信号通路得以表达，可能参与了新生�Objective To study the expression of Glil protein and vascular endothelial growth factor （VEGF）-C in papillary thyroid carcinoma and their relationship with cervical lymph node metastasis. Methods The expression of Glil protein and VEGF-C were investigated by immunohistochemical EnVision method in 67 cases of papillary thyroid carcinoma and 32 cases of nodular goiter pathological specimen tissues. Nascent microvascular and micro-lymphatic of all pathological speimen tissues were examined by immunohistochemical monoclonal antibody CD~ and D2-40 staining assay respectively, and the microvascular density （MVD） and micro-lymphatic vessel density （MLVD） were calculated. The relationship between the positive expression of Glil protein and MVD,between the positive expression of VEGF-C and MLVD,and their relationship with cervical lymph node metastasis were analyzed： Results The positive rates of Glil protein, VEGF-C and MVD, MLVD were significantly higher in papillary thyroid carcinoma than those in nodular goiter [67.16%（45/67） vs. 43.75%（14/32） ,70.15%（47/67） vs. 31.25%（10/32） ,23.14 ＋ 2.06 vs. 2.14 ＋ 0.31,13.36 ＋ 1.32 vs. 3.53 ~ 0.65,P 〈 0.05]. The positive expression of Glil protein was related to the patient＇ s age and the tumor size （P 〈 0.05 ）, while the positive expression of VEGF-C was not related to the patient＇s age and the tumor size （P 〉 0.05）. The positive expression of Glil protein and VEGF- C were significantly higher in TNM stage m - Iv of papillary thyroid carcinoma than those in TNM stage I - I1 （P 〈 0.01 ） and also was significantly higher with cervical lymph node metastasis than without cervical lymph node metastasis （P 〈 0.01 ）. MVD and MLVD were significantly higher with cervical lymph node metastasis than without cervical lymph node metastasis （P 〈 0.05）. The positive expression of Glil protein was positively correlated with MVD （r = 0.784, P 〈 0.01 ）, the positive expression of VEGF-C was positively correlated with MLV

关 键 词：血管内皮生长因子C 甲状腺肿瘤 肿瘤转移 

分 类 号：R736.1[医药卫生—肿瘤]