热消融对甲状腺良性结节组织内HSP70表达的影响

目的探讨甲状腺良性结节射频消融后组织内热休克蛋白70(heat shock protein,HSP70)表达的变化及其潜在意义。方法对50枚甲状腺良性实性结节实施超声引导下射频消融治疗,设定结节的中央区、边缘区和过渡区,于消融前后对应各穿刺取材1次,采用免疫组织化学染色法半定量测定其内HSP70的表达,对比消融前后及消融后不同区域HSP70的表达差异。结果 50枚甲状腺实性结节中央区和边缘区HSP70的表达在消融前、后无明显差异,过渡区HSP70的表达消融后强于消融前(P<0.05);消融治疗后HSP70的表达存在过渡区强于中央区和边缘区(P<0.05),而中央区与边缘区无明显差异。结论热消融治疗过程中存在甲状腺结节周围过渡区HSP70高表达,这可能有助于保护正常腺体组织免受热损伤。

Effect of thermal ablation on HSP70 expression in benign thyroid nodules

Heat shock protein70 (HSP70) is a stress-induced self-protective protein and we postulate an increase in its expression associated with the thermal ablation of thyroid nodules. In this study we aim to explore the change of HSP70 expression after radiofrequency ablation of benign thyroid nodules, and to investigate its potential function during thermal ablation. Method Ultrasound-guided radiofrequency ablation(RFA) was conducted for treating 50 solid thyroid nodules in 50 patients. Three different region of interest(ROI), named as the central region, marginal region and transitional region, were set in each nodule for quantitative investigation of HSP70 expression by using immunohistochemistry method. As a longitudinal comparative study design, each ROI experienced twice histological sampling by using core-needle biopsy before and after RFA. Comparative analysis of HSP70 expression was conducted among the specimen from the three ROIs before ablation and between the specimen from the same ROI before and after ablation respectively. Results Of the 50 solid thyroid nodules, the change of HSP70 expression in the central and marginal region before and after ablation was not significant (P> 0.05), while a significant enhancement in HSP70 occurred in the transitional region after ablation (P <0.05). After ablation, the level of HSP70 in the transitional region was higher than that in both the central and marginal regions (P <0.05), with a result of no significant difference between the latter two regions(P > 0.05). Conclusion During thermal ablation treatment of benign thyroid nodules, increased expression of HSP70 of the transitional region might protect normal glandular tissue against heat damage. However, the protective function of HSP70 within the nodules might have not functioned properly while the temperature rose rapidly and intensively due to the RF electricity.