甲状腺癌ret、ras、p53基因的表达及意义

目的通过对甲状腺癌ret、ras、p53基因研究，揭示其在甲状腺癌发病中的意义，为进一步进行甲状腺癌的防治奠定基础。方法用免疫组织化学方法检测66例甲状腺癌和102例甲状腺良性病变中ret、ras、p53基因的表达并进行比较。结果ret在甲状腺乳头状癌、滤泡状癌、未分化癌、结节性甲状腺肿、桥本病及甲亢中均有表达，在髓样癌和滤泡状腺瘤中未检测到；ras在各型甲状腺病中均有表达，但在乳头状癌、滤泡状腺瘤及桥本病中的阳性率明显高于其他类型，差异有统计学意义（P〈0．05）；p53在各型甲状腺癌中的表达率为20％～50％，良性病变中仅在1例滤泡状腺瘤和3例结节性甲状腺肿中呈阳性。ret、p53在甲状腺癌中的表达显著高于甲状腺良性病变，差异有统计学意义（P=0．001）；ras在甲状腺良恶性病变中均有较高表达，差异无统计学意义（P=1．000）。结论甲状腺癌的发病与癌基因ret、ras及抑癌基因p53的突变有密切联系。ret、p53在甲状腺癌中的表达显著高于甲状腺良性病变；ras在甲状腺良恶性病变中均有较高表达，但在乳头状癌、滤泡状腺瘤及桥本病中的阳性率明显高于其他类型。因此，甲状腺癌的防治除考虑高碘因素外，也应充分注意遗传因素的影响。

Expression of ret, ras, and p53 gene in thyroid cancer

Objective To reveal the significance of ret, ras, and p53 gene expression in the oncogenesis of thyroid cancer. Methods A systematic study on ret, ras, and p53 gene in thyroid cancer was made. Immunohistochemistry was used to detect the expression of let, ras, and p53 in 66 cases of thyroid cancer and 102 cases of benign thyroid lesions. Results let was expressed in thyroid papillary carcinoma, follicular carcinoma, undifferentiated carcinoma, nodular goiter, Hashimoto＇s disease and hyperthyroidism, but not expressed in medullary carcinoma and follicular adenoma, ras was expressed in various types of thyroid disease, with a significantly higher expression in papillary carcinoma, follicular adenoma and Hashimoto＇s disease（ P 〈 0.05 ）. The expression rate of p53 in each type of thyroid carcinoma was 20% -50% , however, it was detected only in 1 case of follicular adenoma and 3 cases of nodular goiter in benign lesions. The expression of ret and p53 was significantly higher in thyroid cancer than in benign lesions（ P = 0. 001 ）. ras was highly expressed in both benign and malignant thyroid lesions, and the difference had no statistical significance （ P = 1. 000）. Conclusions There is a close correlation between thyroid cancer and genic mutation of the oncogene （ ret, ras） and anti-oncogene （ p53 ）. The expression of ret and p53 is significantly higher in thyroid cancer than in benign lesions, ras is highly expressed in both be- nign and malignant thyroid lesions, and the positive rate is significantly higher in papillary carcinoma, follicular adenoma and Hashimoto＇s disease than in other types. Genetic factors should be considered when it comes to prevention and treatment of thyroid cancer.