血清上皮钙黏素、基质金属蛋白酶-2、基质金属蛋白酶-9的表达预测甲状腺微小乳头状癌患者中央区淋巴结转移的价值  

A study of the value of expression of serum E-cadherin,matrix metalloproteinase-2 and matrix metalloproteinase-9 in predicting central lymph node metastasis in the patients with thyroid microcarcinoma

作　　者：朱涛 凌科技[1] 刘斌[1] ZHU Tao;LING Keji;LIU Bin(Department of Otolaryngology Head and Neck Surgery,Hunan Provincial People's Hospital(the First Affiliated Hospital of Hunan Normal University),Changsha,Hunan,410005,China)

机构地区：[1]湖南省人民医院(湖南师范大学附属第一医院)耳鼻咽喉头颈外科,湖南长沙410005

出　　处：《中国耳鼻咽喉头颈外科》2022年第7期409-413,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：湖南省卫生健康委科研计划课题项目(B2019070)。

摘　　要：目的探讨血清上皮钙黏素(E-cadherin)、基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)预测甲状腺微小乳头状癌(papillary thyroid microcarcinoma,PTMC)患者中央区淋巴结转移的价值。方法采用酶联免疫吸附试验法(ELISA)检测湖南省人民医院耳鼻咽喉头颈外科2021年1~10月间收治的符合纳入排除标准的128例PTMC患者术前血清E-cadherin、MMP-2、MMP-9的表达水平,术后病理学确诊52例患者有中央区淋巴结转移,76例患者无中央区淋巴结转移。结果多因素Logistic回归分析结果显示:男性(OR=3.444,P=0.047)、有被膜侵犯(OR=4.930,P=0.010)、血清E-cadherin(OR=33.418,P<0.001)、血清MMP-2(OR=16.533,P<0.001)、血清MMP-9(OR=50.959,P<0.001)水平升高是PTMC发生中央区淋巴结转移的独立危险因素。Pearson相关性分析显示血清MMP-9和MMP-2存在正相关(r=0.299,P<0.05),血清E-cadherin与MMP-2(r=0.014,P=0.874)、血清E-cadherin与MMP-9(r=0.008,P=0.930)两两之间无相关关系;通过受试者工作特征曲线(ROC)分析,血清E-cadherin、MMP-2、MMP-9诊断PTMC颈部淋巴结转移的曲线下面积(AUC)分别为0.675、0.734、0.749,血清E-cadherin联合MMP-2检测、血清E-cadherin联合MMP-9检测、血清M MP-2联合M MP-9检测、三者联合检测的AUC分别为0.780、0.805、0.810、0.866。结论PTMC并颈部淋巴结转移患者血清E-cadherin、MMP-2、MMP-9表达上调,它们可能成为预测PTMC颈部淋巴结转移潜在的生物标志物,联合检测可以提高颈部淋巴结转移的预测效能。OBJECTIVE To investigate the serum e-cadherin,matrix metalloproteinase-2(MMP-2),matrix metalloproteinase-9(MMP-9)in prediction of central lymph node metastasis in papillary thyroid microcarcinoma(PTMC).METHODS The expression levels of serum E-cadherin,MMP-2 and MMP-9 in 128 PTMC patients who met the inclusion and exclusion criteria admitted to Department of Otolaryngology Head and Neck Surgery of Hunan Provincial People’s Hospital from January 2021 to October 2021 were determined by enzymole-linked immunoadsorption assay(ELISA).Postoperative pathology confirmed central lymph node metastasis in 52 patients and no central lymph node metastasis in 76 patients.RESULTS Multivariate Logistic regression analysis results showed that:Male(OR=3.444,P=0.047),membranous invasion(OR=4.930,P=0.010),serum E-cadherin(OR=33.418,P<0.001),serum MMP-2(OR=16.533,P<0.001)and serum MMP-9(OR=50.959,P<0.001)were independent risk factors for central lymph node metastasis of PTMC.Pearson correlation analysis showed that there was a positive correlation between serum MMP-9 and MMP-2(r=0.299,P=0.001),but there was no correlation between serum E-cadherin and MMP-2(r=0.014,P=0.874),and serum E-cadherin and MMP-9(r=0.008,P=0.930).According to receiver operating characteristic curve(ROC)analysis,the AUC of serum E-cadherin,MMP-2 and MMP-9 in diagnosing central lymph node metastasis of PTMC were as follows:0.675,0.734,0.749.The AUC of serum E-cadherin combined with MMP-2,serum E-cadherin combined with MMP-9,serum MMP-2 combined with MMP-9,and combined of the three were 0.780,0.805,0.810,0.866,respectively.CONCLUSION The expression of E-cadherin,MMP-2 and MMP-9 in serum of PTMC patients with central lymph node metastasis are up-regulated,which may become potential biomarkers for predicting central lymph node metastasis of PTMC.Combined detection can improve the prediction efficacy of central lymph node metastasis.

关 键 词：甲状腺肿瘤 基质金属蛋白酶2 基质金属蛋白酶9 预测 甲状腺微小乳头状癌 颈部淋巴结转移 上皮钙黏素 

分 类 号：R736.1[医药卫生—肿瘤]