甲状腺乳头状癌B-raf基因突变及Caveolin-1和COX-2蛋白表达的临床意义  

Clinical significance of B-raf gene mutation and Caveolin-1 and COX-2 protein expressions in papillary thyroid carcinoma

作　　者：张杰东[1] 朱传东[2] 刘杜先[1] 刘兰侠[1] 方媛 ZHANG Jiedong;ZHU ChuANDong;LIU Duxian;LIU Lanxia;FANG Yuan(Department of Pathology,Second Affiliated Hospital of Southeast University,Nanjing 210003;Department of Oncology,Second Affiliated Hospital of Southeast University,Nanjing 210003;Department of Pathology,Nanjing Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]东南大学附属第二医院病理科,南京210003 [2]东南大学附属第二医院肿瘤科,南京210003 [3]南京医科大学附属南京医院病理科,南京210006

出　　处：《临床与病理杂志》2018年第7期1434-1439,共6页Journal of Clinical and Pathological Research

基　　金：江苏省自然科学基金(BK20170134);南京市医学科技发展资金(QRX17154)~~

摘　　要：目的:研究甲状腺乳头状癌(papillary thyroid carcinoma,PTC)中B-raf基因突变率及小凹蛋白-1(Caveolin-1)、环氧化酶-2(COX-2)蛋白表达水平,探讨其临床意义。方法:纳入82例PTC和30例结节性甲状腺肿患者病变标本,应用实时荧光定量PCR检测B-raf基因突变率,应用免疫组织化学SP法检测Caveolin-1,COX-2蛋白表达水平,并分析上述B-raf基因突变率,Caveolin-1和COX-2蛋白表达水平之间的相关性及其与患者临床病理特征的关系。结果:B-raf基因在PTC及结节性甲状腺肿组织的突变率分别为68.29%和0(P<0.01)。B-raf基因突变与PTC患者淋巴结转移、包膜侵犯密切相关(P<0.05),与患者性别、年龄、肿瘤大小、结节数目、TNM分期无关(均P>0.05)。Caveo l i n-1及COX-2在P TC患者标本的表达水平分别为6 9.5 1%和7 9.2 7%,明显高于结节性甲状腺肿组(23.33%,13.33%;P<0.01),其中Caveolin-1蛋白表达与PTC患者淋巴结转移相关(P<0.05),COX-2与颈部淋巴结转移、包膜侵犯相关(均P<0.05),与其他临床病理特征无关。P TC中B-raf基因突变与Caveolin-1蛋白表达呈正相关(P<0.05),B-raf基因突变与COX-2蛋白表达无关(P>0.05)。结论:PTC中B-raf基因突变率较高,同时Caveolin-1和COX-2蛋白表达水平均较高,且B-raf基因突变与Caveolin-1表达密切相关,共同参与PTC浸润及转移,联合检测上述指标有助于提高PTC的早期诊断及预后评估。Objective： To study the clinical significance of B-raf gene mutation and Caveolin-1 and COX-2 expressions in papillary thyroid carcinoma. Methods： We collected tissue samples from 82 cases of papillary thyroid carcinoma and 30 cases of nodular goiter, and we applied Real time-PCR to detect B-raf gene mutation, IHC SP method was carried out to detect the expression level of Caveolin-1,COX-2 protein. Then we analyzed the correlation between B-raf gene mutation ratio with Caveolin-1 and COX-2 expression level, and also analyzed the correlation between above factors with clinical pathology factors statistically. Results： Firstly, the mutation rate of B-raf gene in papillary thyroid carcinoma and nodular goiter were 68.29% and 0（P〈0.01）, and B-raf gene mutation in papillary thyroid carcinoma was closely related to lymph node metastasis, capsular invasion（P〈0.05）, while there was no relation with gender, age, size, number of tumor nodules and TNM stage（P〉0.05）. Secondly, the expression level of Caveolin-1 and COX-2 in papillary thyroid carcinoma were significantly higher（69.51%, 79.27%） than those in nodular goiter（23.33%, 13.33%; P〈0.01）; moreover, the Caveolin-1 protein expression was related with lymph node metastasis（P〈0.05）, and the COX-2 protein expression was related with lymph node metastasis and capsular invasion（P〈0.05）, while Caveolin-1 and COX-2 expression were both not related with other clinicopathological features. Thirdly, B-raf gene mutation in papillary thyroid carcinoma was positively related with Caveolin-1 expression（P〈0.05）, yet not related with COX-2（P〉0.05）. Conclusion： The B-raf gene is highly mutated in papillary thyroid carcinoma, and there are also higher expression of Caveolin-1 and COX-2 in papillary thyroid carcinoma. All above factors are involved in the invasion and metastasis of papillary thyroid carcinoma, implying that combined detection of these three factors may improve the early diagnosis and prognosis assessment of papil

关 键 词：甲状腺乳头状癌 B-raf基因突变 CAVEOLIN-1 COX-2 

分 类 号：R736.1[医药卫生—肿瘤]