甲状腺癌组织c-erbB-2/neu蛋白表达及其临床意义

目的：探讨甲状腺癌中c-erbB-2蛋白（p185）的表达与临床预后因素的相关性及意义。方法：运用免疫组化SP法检测45例甲状腺癌石蜡标本中，p185的表达并与临床预后因素进行相关分析。结果：45例患者中p185蛋白的阳性表达率为71．1％（32／45）。其中乳头状癌的p185为71．0％（22／31）；滤泡癌及髓样癌的p185阳性表达分别为2／4和2／4；未分化癌的p185阳性表达分别为5／6。p185表达与甲状腺癌的组织学类型之间存在明显相关性；与性别及年龄无相关；在有淋巴结转移及有复发、远处转移或死亡的患者中，p185的表达呈明显增强趋势，与无复发组相比较差异有统计学意义，P〈0．05。结论：在甲状腺癌中，p185存在着不同程度的表达，在一定程度上反映了甲状腺癌的组织学分化程度、淋巴结转移和复发倾向；p185的强阳性表达暗示着淋巴结转移概率的增加，将对甲状腺癌的手术方式选择有指导意义；p185的阳性表达可作为判断甲状腺癌预后的临床病理指标。

Expression and clinical significance of c-erbB-2/neu protein in thyroid carcinoma

OBJECTIVE:To investigate the expression of p185 protein and its correlation with clinical prognostic factors in thyroid carcinoma. METHODS: The expression of p185 protein in 45 cases who underwent surgery for treatment of thyroid carcinoma were examined by using SP immunohistochemical method and the corresponding clinical prognostic factors were analysed. RESULTS: The incidence of positive expression of p185 protein was 71.1%(32/45) including 71.0%(22/31) in papillary, 2/4 in follicular and medullary, 5/6 in anaplastic carcinoma. The analysis with corresponding clinical prognostic factors showed that the positive expression of p185 protein in thyroid carcinoma had no correlation with age and sex, but it had a significant correlation with the different histological types, lymph nodes metastases and recurrences or mortality, P<0.05. CONCLUSIONS: The overexpression of p185 protein indicates a tendency toward lymph nodes metastases, recurrences, higher degree of malignancy and poor prognosis. The overexpression of p185 protein implies the enhanced incidence in lymph node metastases, and it will have a significance for the selection of the surgery method in thyroid carcinoma treatment. The positive expression of p185 protein would become a clinicopathologic indicator in prognosis of thyroid carcinoma.