促甲状腺激素受体对分化型甲状腺癌~(131)I治疗效果预测价值

目的通过分析正常甲状腺及分化型甲状腺癌(DTC)组织中促甲状腺激素受体(TSHR)表达位置及表达强度的差异,探讨TSHR对DTC术后131I治疗效果的预测价值。方法回顾性分析DTC术后进行~(131)I清甲治疗患者49例,采用免疫组化ABC法,检测上述病例甲状腺癌组织及癌旁正常甲状腺组织中TSHR的表达位置及表达强度,根据~(131)I治疗效果分组,分析比较两组TSHR表达情况及相关临床资料。结果 49例患者病理切片中,正常甲状腺组织细胞膜TSHR表达阳性率近乎100%,甲状腺癌组织细胞膜TSHR表达阳性率为57.14%,差异有统计学意义(P<0.05);甲状腺癌组织细胞质内TSHR表达阳性率(87.76%)高于正常甲状腺组织(32.65%),差异有统计学意义(P<0.05)。一次性清甲成功患者DTC组织细胞膜上TSHR表达强度(阳性率70.00%及强阳性率46.67%)高于清甲治疗次数≥2次患者(阳性率36.84%及强阳性率15.79%),差异有统计学意义(P<0.05)。结论 DTC细胞膜TSHR的表达强度较正常甲状腺组织低,而其细胞质内TSHR表达强度升高,分化型甲状腺癌细胞膜TSHR表达强度或许能够预测~(131)I治疗效果。

Predictive value of thyrotropin receptor in radioactive iodine therapy of differentiated thyroid carcinoma

Objective To analyze the expression of thyrotropin receptor in normal thyroid tissues and differentiated thyroid carcinoma tissues,and to explore the predictive value of TSHR in radioactive iodine therapy of postoperation differentiated thyroid carcinoma. Methods Totally 49 DTC cases were retrospectively analyzed. All patients were given radioactive iodine therapy after opera-tion. According to the treatment of the radioactive iodine therapy all the patients were divided into two groups. The method of immuno-histochemical avidin-biotin-peroxidase complexes ( ABC) were used to detect the location and intensity of TSHR expression in the tis-sue of thyroid cancer and normal thyroid nearby. The relationship between TSHR and the treament were evaluated combining to clinical data. Results The positive rate of cell basement membrane TSHR expression was 100% in the normal thyroid tissues in the pathologi-cal section and 57. 14% in the DTC tissues(P<0. 05). The positive rate of cytoplasm TSHR expression was 87. 76% in the tumor tis-sues and it was significantly higher than the rate of 32. 65% in the normal thyroid tissues(P<0. 05). In the 49 tumor pathological sec-tions,the TSHR positive expression rate in cell basement membrane ( positive rate 70. 00%and strong positive rate 46. 67%) was high-er in the group who were give only once thrapy when successful thyroid clear than the other group ( positive rate 36. 84% and strong positive rate 15. 79%(P<0. 05). Conclusion Expression of TSHR in the cell basement membrane is lower in the DTC than normal thyroid tissue. There is higher cytoplasm TSHR positive expression in the DTC than normal thyroid tissue. High positive expression of TSHR in the basement membrane of thyroid follicular cells may indicate good effect of the radioactive iodine therapy.