甲状腺乳头状癌组织中p-Akt及VEGF-C的表达及临床意义  

Expression and clinical significance of p-Akt and VEGF-C in papillary thyroid carcinoma tissues

作　　者：郭灵敏[1] 冯伟兆[2] 李林株[1] 赖勇强[2] 严其欢 GUO Lingmin;FENG Weizhao;LI Linzhu;LAI Yongqiang;YAN Qihuan(Department of Pathology,Gaoming District People's Hospital of Foshan City in Guangdong Province,Foshan528500,China;Department of General Surgery,Gaoming District People's Hospital of Foshan City in Guangdong Province,Foshan528500,China)

机构地区：[1]广东省佛山市高明区人民医院病理科,广东佛山528500 [2]广东省佛山市高明区人民医院普外科,广东佛山528500

出　　处：《中国现代医生》2020年第26期12-15,19,共5页China Modern Doctor

基　　金：广东省佛山市卫生和健康局医学科研课题立项(20200164)。

摘　　要：目的探讨甲状腺乳头状癌(papillary thyroid carcinoma)组织磷酸化蛋白激酶B(p-Akt)、血管内皮细胞生长因子-C(VEGF-C)表达水平,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。方法选取我院2012年1月~2018年12月的甲状腺乳头状癌病理标本70例(研究组),另选取正常甲状腺组织31例(对照组),应用免疫组化SP法测定p-Akt、VEGF-C、D2-40在两组中的表达情况,并分析其与临床病理的关系。结果甲状腺乳头状癌组织中p-Akt、VEGF-C、D2-40(MLVD)的阳性表达率分别为60.0%、66.0%、(10.37±2.61),均显著高于正常甲状腺组织的9.7%、6%、(3.08±0.93)(P<0.01)。p-Akt、VEGF-C在甲状腺乳头状癌组织的表达和临床分期、颈部淋巴结转移及MLVD有关,且差异有统计学意义(P<0.05),与肿瘤大小、年龄及性别无关,差异无统计学意义(P>0.05)。甲状腺乳头状癌组织中p-Akt、VEGF-C蛋白表达水平呈正相关(r=0.455,P<0.05),有颈部淋巴结转移患者的MLVD显著高于无颈部淋巴结转移患者,差异有统计学意义(P<0.01)。结论甲状腺乳头状癌组织中p-Akt、VEGF-C呈过表达状态,共同参与淋巴结的侵袭与转移,两个通路可能存在相关性,阻断PI3K/Akt通路有望为甲状腺乳头状癌的靶向治疗提供一种新的思路。Objective To investigate the expression levels of phosphorylated protein kinase B(P-PKB,also p-Akt)and vascular endothelial growth factor-C(VEGF-C)in papillary thyroid carcinoma tissues,and their relationships with clinicopathological features of papillary thyroid carcinoma and cervical lymph node metastasis.Methods 70 pathological specimens of papillary thyroid carcinoma in our hospital from January 2012 to December 2018 were selected as the study group and another 31 cases of normal thyroid tissues were selected as the control group.The expressions of p-Akt,VEGF-C and D2-40 in the two groups were tested by immunohistochemical SP method,and the relationships with clinical pathology were analyzed.Results The positive expression rates of p-Akt,VEGF-C and D2-40(MLVD)in papillary thyroid carcinoma tissues were 60.0%,66.0%and(10.37±2.61),respectively,which were significantly higher than 9.7%,6.0%and(3.08±0.93)in normal thyroid tissues(P<0.01).The expressions of p-Akt and VEGF-C in papillary thyroid carcinoma tissues were related to clinical stage,cervical lymph node metastasis and MLVD,with statistically significant differences(P<0.05),but not related to tumor size,age and gender,and the differences were statistically insignificant(P>0.05).The protein expression levels of p-Akt and VEGF-C in papillary thyroid carcinoma tissues were positively correlated(r=0.455,P<0.05).The MLVD of the patients with cervical lymph node metastasis was significantly higher than that of the patients without cervical lymph node metastasis,and the difference was statistically significant(P<0.01).Conclusion P-Akt and VEGF-C were over-expressed in papillary thyroid carcinoma tissues,and they were jointly involved in the invasion and metastasis of lymph nodes.There may be correlation between the two pathways,and blocking PI3K/Akt pathway is expected to provide a new idea for targeted treatment of papillary thyroid carcinoma.

关 键 词：甲状腺乳头状癌 血管内皮细胞生长因子-C 磷酸化蛋白激酶B 淋巴结转移 

分 类 号：R736.1[医药卫生—肿瘤]