E-cadherin和CK19表达与甲状腺乳头状癌患者临床病理特征和复发的关系

目的:探讨上皮型钙黏附素（E-cadherin）和角蛋白19（CK19）与甲状腺乳头状癌（PTC）患者临床病理特征及复发的关系。方法:收集2012年7月至2015年6月期间在广元市中心医院行外科手术的PTC患者130例，随访患者复发情况。采用免疫组织化学染色法（IHC）检测所有PTC患者肿瘤组织和癌旁正常组织E-cadherin和CK19的表达。结果:肿瘤组织中E-cadherin阳性表达率为41.54%（54/130），明显低于癌旁组织，且与肿瘤腺体包膜浸润、淋巴结转移数量有关（P＜0.05）；而CK19阳性表达率为66.92%（87/130），明显高于癌旁正常组织，与肿瘤大小、腺体包膜浸润、TNM分期有关（P＜0.05）。E-cadherin在PTC组织中的表达与CK19呈负相关性（rk=-0.239，P=0.026）。14例（11.38%）患者术后复发。E-cadherin阳性表达者无病生存率高于阴性表达者（P＜0.05）。另外，CK19阳性表达者无病生存率低于阴性表达者（P＜0.05）。经多因素logistic回归分析，腺体包膜浸润、E-cadherin低表达和CK19高表达是术后复发的独立影响因素（P＜0.05）。结论:肿瘤组织中E-cadherin低表达和CK19高表达可作为PTC患者术后复发的预警标志物，有助于筛选术后复发的高危患者。

Relationship between E-cadherin,CK19 expression and clinicopathological characteristics and recurrence in papillary thyroid carcinoma

Objective:To analyze the expressions of epithelial cadherin (E-cadherin) and cytokeratin 19 (CK19) in papillary thyroid carcinoma (PTC) and their relationship with recurrence of PTC patients.Methods:The research enrolled 130 PTC patients from July 2012 to June 2015 retrospectively.The recurrence during followed-up was recorded.The expressions of E-cadherin and CK19 were detected by immunohistochemical (IHC) staining method.Results:The positive expression rate of E-cadherin in PTC tissues was 41.54%(54/130),which was lower than that in adjacent cancer tissues (P＜0.05).The expression rate of E-cadherin in PTC tissues was related with extrathyroid invasion and number of metastatic lymph nodes (P＜0.05).The positive expression rate of CK19 in PTC tissues was 66.92%(87/130),which was higher than that in adjacent cancer tissues (P＜0.05).E-cadherin expression was negatively related with CK19 in PTC tissue (rk=-0.239,P=0.026).There were 14 patients (11.38%) with recurrence.The non-recurrence survival of PTC patients with positive E-cadherin expression and negative CK19 expression was higher than these patients with negative E-cadherin expression and positive CK19 expression (P＜0.05).The extrathyroid invasion,low E-cadherin level and high CK19 level were the independent risk factors of recurrence after surgery by multivariate logistic regression analysis (P＜0.05).Conclusion:There are significant evidences that the abnormal expressions of E-cadherin and CK19 could be the predictors of recurrence after surgery in patients with papillary thyroid carcinoma.