CyclinD1、p27表达与甲状腺微小乳头状癌中央区淋巴结转移超声特征的关系  

Relations between the expression of cyclinD1,p27 and the ultrasonographic features of central lymph node metastasis in the PTMC

作　　者：叶丹 章佳波 姚玲莉 郭宇[2] Ye Dan;Zhang Jiabo;Yao Lingli;Guo Yu(Ningbo University School of Medicine, Ningbo 315211, China;Department of Breast and Thyroid Surgery, Plastic Cosmetic Center, Ningbo First Hospital, Ningbo 315010, China)

机构地区：[1]宁波大学医学院,浙江宁波315211 [2]宁波市第一医院,甲状腺乳腺外科、整复美容中心,浙江宁波315010

出　　处：《临床荟萃》2021年第3期262-265,共4页Clinical Focus

基　　金：浙江省医学会临床研究基金——术中冰冻切片p27和Cyclin D的表达水平在甲状腺微小乳头状癌患者发生颈部淋巴结转移的研究(2017ZYC-A52)。

摘　　要：目的探讨甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)病灶的细胞周期蛋白D1(cyclinD1)、p27表达情况与其中央区淋巴结转移超声特征之间的关系。方法收集我院行中央区淋巴结清扫术的PTMC患者60例。记录所有病例的超声特征,采用免疫组织化学的方法检测甲状腺肿瘤组织标本的cyclinD1、p27表达。根据术后病理检查结果分为中央淋巴结转移组和中央区淋巴结未转移组。分析超声特征与中央区淋巴结转移的关系;分析cyclinD1、p27表达与中央区淋巴结转移及超声特征的关系。结果超声特征中结节边界、存在钙化、纵横比≥1以及多灶性与中央区淋巴结转移相关(P<0.05)。CyclinD1高表达联合p27低表达与中央区淋巴结转移存在相关性(P<0.05)。cyclinD1高表达更容易发生结节边界不清、存在钙化或纵横比≥1(P<0.05);p27低表达的也容易发生纵横比≥1(P<0.05)。结论结节边界不清、存在钙化伴cyclinD1高表达时,或纵横比≥1伴cyclinD1高表达或p27低表达时,中央区淋巴结转移可能性较大,需行预防性中央区淋巴结清扫。Objective To investigate the relations between the expression of cyclinD1,p27 and ultrasonographic features of central lymph node metastasis in the papillary thyroid microcarcinoma(PTMC).Methods Sixty patients with PTMC receiving central lymph node dissection in the hospital were selected,ultrasonographic features of all cases were recorded,and the expressions of cyclinD1 and p27 in thyroid tumor tissues were detected by immunohistochemical method.The patients were divided into two groups including the central lymph node metastasis group and central lymph node non-metastasis group based on results of postoperative pathological examinations,the relations between ultrasound features and central lymph node metastasis were analyzed,and relations between the expressions of CyclinD1 and P27 in central lymph node metastasis and ultrasound features were analyzed.Results In ultrasound features,the nodular boundary,calcification,aspect ratio≥1 and multifocus in ultrasound features were related with central lymph node metastasis(P<0.05).High expression of CyclinD1 combined with low expression of p27 had a correlation with central lymph node metastasis(P<0.05).The patients with high expression of cyclinD1 were more likely to have unclear boundary of nodules,calcification or aspect ratio≥1(P<0.05),and the patients with low expression of p27 are also prone to have the aspect ratio≥1(P<0.05).Conclusion When nodules with unclear boundaries,calcification and high expression of cyclinD1 or when the aspect ratio≥1 complicated with high expression of cyclinD1 or lower expression of p27,the possibility of central lymph node metastasis is high,hence,it is necessary to take prophylactic central lymph node dissection.

关 键 词：癌 乳头状 甲状腺肿瘤 淋巴转移 细胞周期蛋白D1 

分 类 号：R730.261[医药卫生—肿瘤]