nm23基因在人甲状腺乳头状癌的表达及其与淋巴结转移的关系

应用免疫组化ＡＢＣ法检测１００例甲状腺乳头状癌标本中ｎｍ２３基因产物二磷酸核苷激酶（ＮＤＰＫ）的表达。结果总阳性率６７％，其中无淋巴结转移组阳性率８５％（３４／４０），伴有淋巴结转移组阳性率５５％（３３／６０）（Ｐ＜０．０１）；未侵犯包膜组阳性率７９％（３０／３８），侵犯包膜组阳性率６０％（３７／６２）（Ｐ＜０．０５），提示ｎｍ２３基因在甲状腺乳头状癌的表达与淋巴结转移及包膜侵犯呈负相关关系。结果还显示，在ｎｍ２３基因表达阳性的病例中，未侵犯包膜与侵犯包膜组淋巴结转移率分别是７％（２／３０）及８４％（３１／３７），（Ｐ＜０．０１），提示尽管ｎｍ２３阳性，侵犯包膜组明显比未侵犯包膜组淋巴结转移机会大；在未侵犯包膜的病例中，ｎｍ２３（－）及ｎｍ２３（＋）病例的淋巴结转移率分别是７５％（６／８）及７％（２／３０）（Ｐ＜０．０５），提示尽管未侵犯包膜，但在ｎｍ２３阴性时，淋巴结转移的可能性仍很大。结论：本检测有助于探讨代表甲状腺乳头状癌转移趋势的分子生物学标志，更科学地选择手术方式。

NDPK/nm23 Expression in Human Thyroid Papillary Carcinoma and Its Relation to Lymph Node Metastasis

Expression of nucleotide diphosphate kinase (NDPK), the main product of metastatic suppressor gene nm23 in 100 patients with thyroid papillary carcinoma was examined immunohistochemically. Sixty seven cases (67%) showed positive staining. The positive rates of this series in cases without lymph node metastasis,with lymph node metastasis, without capsular invasion and with capsular invasion were 85% (34/40), 55% (33/60 P < 0.01 ), 79% (30/38), 60% (37/62 P <0.05) respectively. The results indicated that the expression of nm23 gene was negatively correlated with involvement of lymph node and that the lymph node metastatic rate in patients with capsular invasion 84% (31/37) was higher than that without capsular invasion 7% (2/30) with P value less than 0.01. The results also indicated that even when the capsule was not invaded and the nm23 was negative, the probability of lymph node metastasis was still high. It is concluded that determination of nm23 gene might be a helpful molecular biological marker for evaluating the propensity to lymph node metastasis of thyroid papillary carcinoma and that it is helpful in making surgical operation decision judiciously.