促甲状腺激素受体在分化型甲状腺癌组织中的表达及意义  

Expression of thyroid stimulating hormone receptor in differentiated thyroid carcinoma and its clinical significance

作　　者：李清怀[1] 张晓娟[1] 李筱雨[1] 底旺[1] 张霖雷[1] 

机构地区：[1]河北医科大学第二医院腺体外科,石家庄050017

出　　处：《中华肿瘤杂志》2013年第10期751-753,共3页Chinese Journal of Oncology

摘　　要：目的 探讨促甲状腺激素（TSH）受体在分化型甲状腺癌中的表达及意义.方法 采用免疫组化染色检测74例分化型甲状腺癌患者和28例结节性甲状腺肿患者甲状腺组织中TSH受体的表达,分析其与分化型甲状腺癌患者TNM分期和淋巴结转移的关系.结果 TSH受体在结节性甲状腺肿组织中的阳性表达率为89.3％,明显高于分化型甲状腺癌组织（55.4％；x2=10.21,P＜0.05）.TSH受体在Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期分化型甲状腺癌组织中的阳性表达率分别为75.9％、47.8％、38.9％和25.0％,随着临床分期的升高,阳性表达率逐渐下降.统计学分析的结果显示,TSH受体的表达与分化型甲状腺癌的TNM分期相关（P＜0.05）,而与淋巴结转移无关（P＞0.05）.结论 TSH受体在分化型甲状腺癌组织中的阳性表达率较低,且随着TNM分期的增加,TSH受体的阳性表达率逐渐下降.TSH受体表达水平的检测可为分化型甲状腺癌患者术后进行TSH抑制治疗提供依据.Objective To explore the expression of thyroid stimulating hormone （TSH） receptor in differentiated thyroid carcinoma and its clinical significance. Methods Seventy-four patients with differentiated thyroid carcinoma treated in our department from January 2009 to January 2011 were selected as the observation group, and 28 patients with nodular goiter were selected as the control group. Expression of TSH receptor in the two groups were detected by immunohistochemistry. Results The positive rate of TSH receptor expression in the observation group was 55.4 （41/74）, significantly lower than that of the control group （89.3%, 25/28）, with a significant difference between the two groups （X2 = 10.21, P 〈 0.05）. In the observation group, the positive rate of TSH receptor expression was 75.9%（22/29） in the stage I patients, 47.8% （11/23） in the stage Ⅱ patients, 38.9%6 （7/18） in the stage Ⅲ patients, and 25.0% （1/4） in the stage Ⅳ patients. Along with the increase of TNM staging, the positive rate of TSH receptor expression was decreased gradually, with a significant difference between them （X2 = 8.93, P 〈 0.05）. The positive rate of TSH receptor expression was 53.8% （14/26） in the lymph node metastasis positive group and 56.3 % （27/48） in the lymph node metastasis negative groups, with a non-significant difference between them （X2 = 0.04, P 〉 0.05）. Conclusions Expression of TSH receptors in the patients with differentiated thyroid carcinoma is quite low, and along with the increase of TNM staging, its positive rate is decreasing gradually. Testing the expression of TSH receptor may provide a basis for TSH suppression therapy after thyroid cancer surgery. This TSH suppression therapy should be personalized in order to reduce the side effects and improve their quality of life.

关 键 词：甲状腺肿瘤 免疫组织化学 促甲状腺激素受体 治疗 

分 类 号：R736.1[医药卫生—肿瘤]