乳头状甲状腺癌患者血清和甲状腺组织中白细胞介素6 水平的检测及其意义

目的：探讨白细胞介素6（IL-6）与乳头状甲状腺癌（PTC）发病的关系，阐明IL-6在PTC发生发展中的作用及其可能机制。方法：收集5例PTC患者（病例1组）、5例桥本甲状腺炎（HT）并发PTC患者（病例2组）和5名查体正常人（正常组）的血清，采用酶联免疫吸附（ELISA）法检测各组研究对象血清中IL-6水平。收集20例PTC （PTC组）、15例HT并发PTC患者（HT+PTC组）病变甲状腺组织和18名正常人（对照组）甲状腺组织，采用免疫组织化学（IHC）法检测各组研究对象甲状腺组织中IL-6、IL-6受体（IL-6R）、核因子κB （NF-κB）和RET/PTC蛋白表达阳性率；分析IL-6、IL-6R与RET/PTC、NF-κB表达的关联性。结果：PTC患者甲状腺组织内上皮细胞复杂乳头状增生伴细胞核毛玻璃样，并见核沟及核内包涵体；HT并发PTC患者甲状腺组织中除了PTC典型病变外，还可以看见弥漫淋巴组织浸润伴淋巴滤泡形成，增生与萎缩甲状泡上皮共存伴甲状腺上皮嗜酸性变，间质纤维化；正常甲状腺组织小叶结构存在，滤泡细胞大小一致。ELISA法检测，PTC组和HT并发PTC组患者血清IL-6水平高于正常组（P<0.05）；IHC法检测，PTC组患者甲状腺组织中IL-6、IL-6R、NF-κB和RET/PTC表达阳性率高于对照组（P<0.05）。IL-6、IL-6R与NF-κB、RET/PTC蛋白表达有关联（P<0.05）。结论：IL-6可能通过RET/PTC-NF-κB信号通路参与PTC的发生发展。

Detection of interleukin-6 levels in serum and thyroid tissue of patients with papillary thyroid carcinoma and their significances

Objective:To investigate the relationship between interleukin-6 (IL-6) and papillary thyroid carcinoma (PTC), and to elucidate the role of IL-6 in the occurrence and development of PTC and its possible mechanism. Methods:The serum levels of IL-6 were measured by ELISA method in 5 patients with PTC(case 1 group), 5 patients with Hashimoto thyroiditis (HT) complicated with PTC(case 2 group) and 5 normal persons(normal group). The thyroid tissues of 20 patients with PTC(PTC group), 15 patients with HT complicated with PTC(HT +PTC group) and 18 normal persons(control group) were collected. The positive expression rates of IL-6, IL-6 receptor (IL-6R), nuclear factor kappa-B(NF-κB) and RET/PTC proteins in thyroid tissue of the subjects in various groups were detected by immunohistochemistry(IHC) method; the relationships between IL-6, IL-6R and NF-κB, RET/PTC expressions were analyzed. Results:In the patients with PTC, the complex papillary hyperplasia of thyroid epithelial cells accompanying with ground glass like nuclei and nuclear sulcus and inclusions were seen; in the patients with HT complicated with PTC, in addition to the typical pathological changes of PTC, the diffuse lymphoid tissue infiltration accompanying with lymphoid follicle formation,and the coexistence of hyperplasia and atrophic thyroid follicular epithelium with eosinophic degeneration of thyroid epithelium and interstitial fibrosis were also found. The lobular structrure of normal thyroid tissue was found,and the follicular cells were in the same size The ELISA results showed that the serum IL-6 levels of the patients in PTC group and HT+ PTC group were higher than those in normal group (P<0.05);the IHC results showed that the positive expression rates of IL-6, IL-6R, NF-κB, and RET/PTC in thyroid tissue of the patients in PTC group were higher than those in control group (P<0.05). The expressions of IL-6,and IL-6R were positively correlated with the expressions of NF-κB and RET/PTC protein (P<0.05). Conclusion:IL-6 may be involved in the occurrence and development of PTC through the RET/PTC-NF-B signal pathway.