促甲状腺激素抑制疗法对甲状腺癌组织PD-L1、MMP-2表达及患者预后的影响  

Effects of thyroid-stimulating hormone suppressive therapy on programmed death ligand 1 and matrix metalloproteinase-2 expression in thyroid cancer tissue and prognosis

作　　者：李坤[1] 刘凯 田加禾 李村夫 Li Kun;Liu Kai;Tian Jiahe;Li Cunfu(Department of Thyroid Surgery,Weihai Central Hospital,Qingdao University,Weihai 264400,Shandong Province,China;Department of Otolaryngology-Head and Neck Surgery,Weihai Municipal Hospital,Weihai 264200,Shandong Province,China;Department of Ultrasound,Weihai Central Hospital,Qingdao University,Weihai 264400,Shandong Province,China)

机构地区：[1]青岛大学附属威海市中心医院甲状腺外科,威海264400 [2]威海市立医院耳鼻咽喉头颈外科,威海264200 [3]青岛大学附属威海市中心医院超声科,威海264400

出　　处：《中国基层医药》2023年第9期1304-1307,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的:探讨促甲状腺激素(TSH)抑制疗法对甲状腺癌组织程序性死亡配体1(PD-L1)、基质金属蛋白酶2(MMP-2)表达及患者预后的影响。方法:收集2016年4月至2018年4月在青岛大学附属威海市中心医院行手术切除的甲状腺癌患者102例,根据术后采用的治疗方法分为激素替代组和TSH抑制组,每组51例。激素替代组于手术切除后给予激素替代治疗,TSH抑制组则给予TSH抑制治疗,比较两组术中、术后3个月、术后6个月时切除癌组织周围组织中PD-L1、MMP-2阳性表达情况及两组随访6个月、1年、3年的肿瘤复发、转移情况。结果:术后3个月、6个月时,TSH抑制组PD-L1、MMP-2阳性表达率分别为9.8%(5/51)、13.7%(7/51)和9.8%(5/51)、13.7%(7/51),明显低于激素替代组的25.5%(13/51)、31.4%(16/51)和27.5%(14/51)、33.3%(17/51)(χ^(2)=4.32、5.24、4.55、5.45,P=0.038、0.022、0.033、0.020);随访3年时,TSH抑制组肿瘤复发转移率为5.9%(3/51),明显低于激素替代组的17.6%(10/51)(χ^(2)=4.32,P=0.038)。结论:对甲状腺癌手术患者,术后采用TSH抑制疗法能较好地抑制切除癌组织周围组织中PD-L1、MMP-2的表达水平,降低其远期复发转移风险,对患者术后预后改善有着较高的临床应用价值。Objective To investigate the effects of thyroid-stimulating hormone(TSH)suppressive therapy on the expression of programmed death ligand 1(PD-L1)and matrix metalloproteinase 2(MMP-2)in thyroid cancer tissue and prognosis.Methods A total of 102 patients with thyroid cancer who underwent surgical resection in Weihai Central Hospital,Qingdao University from April 2016 to April 2018 were included in this study.They were divided into a hormone replacement group and a TSH suppressive therapy group(n=51/group).The hormone replacement group was given hormone replacement therapy after surgical resection,and the TSH suppressive therapy group was given TSH suppressive therapy.The expression of PD-L1 and MMP-2 in the pericancerous tissue was compared between the two groups during surgery and 3 and 6 months after surgery.Tumor recurrence and metastasis were compared between the two groups after 6 months,1 year,and 3 years of follow-up.Results At 3 and 6 months after surgery,the PD-L1 positive expression rate in the TSH suppressive therapy group was 9.8%(5/51)and 13.7%(7/51),respectively,and the MMP-2 positive expression rate in the TSH suppressive therapy group was 9.8%(5/51)and 13.7%(7/51),respectively,which were significantly lower than 25.5%(13/51),31.4%(16/51),27.5%(14/51),and 33.3%(17/51)in the hormone replacement group(χ^(2)=4.32,5.24,4.55,5.45,P=0.038,0.022,0.033,0.020).At 3 years after surgery,the tumor recurrence and metastasis rate in the TSH suppressive therapy group was 5.9%(3/51),which was significantly lower than 17.6%(10/51)in the hormone replacement group(χ^(2)=4.32,P=0.038).Conclusion For patients with thyroid cancer undergoing surgery,TSH suppressive therapy can better inhibit the expression of PD-L1 and MMP-2 in thyroid cancer tissue,reduce the risk of long-term recurrence and metastasis,and have a better clinical application value for improving the prognosis compared with hormone replacement therapy.

关 键 词：甲状腺肿瘤 激素替代疗法 促甲状腺素 程序性细胞死亡受体1 基质金属蛋白酶2 预后 复发 肿瘤转移 

分 类 号：R736.1[医药卫生—肿瘤]