外周血TSHR-mRNA检测在甲状腺乳头状癌中的临床意义  

The clinical significance of peripheral blood TSHR-mRNA detection in papillary thyroid carcinoma

作　　者：郝少龙 马纪红 刘新承 许洁[4] 宁进尧[3] 吴国长[3] 刘日明[5] 郑海涛[3] 

机构地区：[1]首都医科大学附属北京潞河医院普外科 [2]首都医科大学附属北京潞河医院通科内科 [3]青岛大学医学院附属烟台毓璜顶医院甲状腺外科 [4]青岛大学医学院附属烟台毓璜顶医院肿瘤内科 [5]青岛大学医学院附属烟台毓璜顶医院分子生物学检验科

出　　处：《中华普外科手术学杂志（电子版）》2017年第6期491-495,共5页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：山东省自然科学基金(ZR2015HL092);烟台市科技发展计划(2015YT06000060)~~

摘　　要：目的探讨外周血促甲状腺激素受体mRNA(TSHR-mRNA)检测在甲状腺乳头状癌诊断中的应用价值。方法收集2015年4月至2015年12月104例甲状腺疾病患者资料,以术后常规病理为诊断标准进行分组,并以11例健康对照者作为校正标准,应用RT-PCR技术检测其手术前、后外周血TSHR-mRNA的表达情况,用SPSS 17.0软件进行统计学分析,手术前后患者外周血TSHR-mRNA表达量以均值±标准差表示,t检验;通过分析ROC曲线,确定TSHR-mRNA对PTC的诊断阈值,P<0.05为差异有统计学意义。结果甲状腺乳头状癌患者组术前外周血TSHR-mRNA表达量明显高于甲状良性病变患者组、健康对照组;且术前外周血TSHR-mRNA的表达量在不同性别、年龄、病灶大小、病灶数目以及是否合并桥本氏甲状腺炎组间无统计学意义(P>0.05),而在甲状腺癌是否合并被膜侵犯、淋巴结转移以及B-raf V600E基因突变差异有统计学意义(P<0.05)。甲状腺癌患者术后1d,其外周血TSHR-mRNA表达量明显降低。通过ROC分析外周血TSHR-mRNA对甲状腺癌的诊断截断值为1.7时其诊断甲状腺癌的敏感度为:60%,特异度为:82.4%,阳性预测值为:87.5%,阴性预测值为:50%,准确率:为67.3%。结论外周血TSHR-mRNA检测可作为甲状腺乳头状癌的无创检测指标,有可能在成为预测预后、辅助分期、术后随访、监测复发和转移的新指标。Objective To explore the value of peripheral blood thyroid-stimulating hormone receptor mRNA （ TSHR-mRNA） testing in the diagnosis of papillary thyroid carcinoma . Methods 104 patients ＆#39; data in the period between April 2015 and December 2015 were collected .The 104 cases of thyroid disease were devided into different groups based on the postoperative pathology , and 11 cases of healthy were the control group .The expression situation of pre-and postoperative peripheral blood TSHR-mRNA was detected by absolute quantitative real-time PCR, and analyzed with the patients ＆#39; clinical data.The expression of peripheral blood TSHR-mRNA before and after surgery was represented by （ x-±s） .The diagnostic threshold value of TSHR-mRNA to PTC was determined.Statistical significance was set as P〈0.05. Results The expression level of peripheral blood TSHR-mRNA in the papillary thyroid carcinoma patients group was＆amp;nbsp;significantly higher than that in the benign thyroid disease patients group and healthy group .And the expression of preoperative peripheral blood TSHR mRNA has no relation with the patients ＆#39; gender, age, fo-cal size, the number of lesions and whether or not Hashimoto Thyroiditis （P 〉0.05）, but has obvious relationship with whether or not capsular invasion , lymph node metastasis and B-rafV600E gene mutation （P〈0.05）.At the first postoperative day, the express quantity of papillary thyroid carcinoma patients ＆#39; peripheral blood TSHR-mRNA was decreased obviously and has no obvious difference with the benign thyroid disease group （ P 〉0.05 ）.The accuracy rate of diagnosing thyroid papillary carcinoma by thyroid ultrasound, preoperative peripheral blood TSHR-mRNA detection and the combination of both were 70.2%, 67.3%and 78.8%, respectively. Conclusion The peripheral blood TSHR-mRNA detection can be used as the noninvasive detection index of diagnosis papillary thyroid carcinoma .Its expression level can be a representative of whether the tumor associated wit

关 键 词：甲状腺肿瘤 受体 促甲状腺素 

分 类 号：R736.1[医药卫生—肿瘤]