甲状腺髓样癌降钙素及其基因相关肽检测的临床意义——附88例报告(英文)

目的研究甲状腺髓样癌患者降钙素及其基因相关肽的变化规律,指导临床治疗方案的选择和患者预后的判断。方法回顾性研究包括对58例甲状腺髓样癌病例血清中降钙素的分析及应用免疫组织化学方法观察相应标本中降钙素及其基因相关肽的表达情况;对新入组30例病例进行放射免疫学测定。结果 (1)术后1个月降钙素水平正常与升高的患者之间,肿瘤复发存在显著性差异(P<0.01)。(2)约98%的患者肿瘤标本降钙素染色呈阳性,而降钙素基因相关肽的阳性率为87.8%。(3)部分术前降钙素水平正常的患者降钙素基因相关肽水平升高。(4)术后1周左右降钙素下降至一稳定水平。结论降钙素可以作为指导甲状腺髓样癌诊断和治疗的重要指标,检测降钙素基因相关肽有助于部分降钙素阴性的甲状腺髓样癌患者术前诊断。

Investigation of Calcitonin and Calcitonin Gene-related Peptide in 88 Cases of Medullary Thyroid Carcinoma

Objective:To investigate the changes of calcitonin(CT)and calcitonin gene-related peptide (CGRP)in patients with medullary thyroid carcinoma(MTC).Methods:Fifty-eight cases of MTC were selected and the relationship between the CT levels and metastasis was investigated.The immunohisto- chemical method was used to detect the expression of CT and CGRP in the 58 samples of MTC tissues. The CT and CGRP in 30 newly diagnosed MTC inpatients were measured before operation and in the first few days after operation using a radioimmunoassy.Results:(1)The rate of residual tumor had a significant difference between the normal serum CT group one month after operation and the elevated group at the same period(P<0.01).(2)Immunohistochemical study revealed the positive rate of CT was about 98%,and that of the CGRP was 87.8%.(3)Part of the patients had an elevated CGRP levels while CT levels was normal.(4)The serum CT levels were decreased to a stable range one week after operation. Conclusion:CT is a useful index to evaluate the efficacy of surgical treatment.The measurement of serum CGRP is helpful in the diagnosis of MTC,especially for those whose preoperative CT levels are normal.