CK-20和LGALS4在甲状腺乳头状癌中的表达及临床意义

目的探讨角蛋白-20(cytokeratin-20,CK-20)和半乳糖凝集素4(galectin-4,LGALS4)在甲状腺乳头状癌中的表达及其临床意义。方法选取2010年1月-2014年6月在张家口市第一医院手术且经病理证实的甲状腺乳头状癌患者128例为研究对象,免疫组化检测癌组织及相应癌旁正常甲状腺组织CK-20、LGALS4的表达;ROC曲线分析CK-20、LGASL4对甲状腺乳头状癌的诊断价值;多因素Cox回归分析影响患者无病生存期(disease-free survival,DFS)的因素。结果甲状腺乳头状癌组织中CK-20阳性表达率高于癌旁正常组织,而LGALS4阳性表达率低于癌旁正常组织(均P<0.05);CK-20高表达、LGALS4低表达均与肿瘤远处转移、TNM分期、淋巴结转移有关(均P<0.05);CK-20与LGALS4表达水平呈负相关(r=-0.531,P<0.001);CK-20、LGALS4联合诊断甲状腺乳头状癌的曲线下面积、敏感度均优于其单独诊断(均P<0.05);CK-20阳性表达患者5年DFS低于阴性表达患者,而LGALS4阳性表达患者5年DFS高于阴性表达患者(均P<0.05);CK-20高表达、远处转移、淋巴结转移是DFS的独立危险因素,而LGALS4高表达是DFS的保护因素(均P<0.05)。结论甲状腺乳头状癌组织中CK-20与LGALS4表达呈负相关,CK-20高表达预示预后不良,而LGALS4高表达预示预后良好,两者有望成为监测甲状腺乳头状癌预后的生物标志分子。

Expression of CK-20 and LGALS4 in papillary thyroid carcinoma and its clinical significance

Objective To investigate the expression of cytokeratin-20 （CK-20） and galectin-4 （LGALS4） in papillary thyroid carcinoma and its clinical significance. Methods A total 128 patients with pathologically confirmed papillary thyroid carcinoma who were operated in the First Hospital of Zhangjiakou from January 2010 to June 2014，were selected as the investigated subjects，from whom surgical cancer tissues and the corresponding adjacent normal tissues were collected. The expressions of CK-20 and LGALS4 was detected by immuno-histochemistry；the diagnostic value of CK-20 and LGASL4 in papillary thyroid carcinoma was analyzed by the ROC curve；the influence factors of disease-free survival（DFS） was analyzed by multivariable Cox regression. Results The positive expression rate of CK-20 in papillary thyroid carcinoma was higher than that in adjacent normal tissues，while the expression of LGALS4 was lower than that in adjacent normal tissues（all P<0.005）. The high expression of CK-20 and low expression of LGALS4 were related to distant tumor metastasis，TNM stage，and lymph node metastasis （all P<0.05），and CK-20 expression was negatively correlated with LGALS4 expression level （r=-0.531，P<0.001）. The area under the curve and sensitivity of the combined diagnosis of CK-20 and LGALS4 in thyroid papillary carcinoma was better than their single diagnosis （all P<0.05）. The 5-year DFS of patients with CK-20 positive expression was lower than that of negative expression patients，while the 5-year DFS of LGALS4 positive expression patients was higher than that of negative expression patients （all P<0.05）. The high expression of CK-20，distant metastasis and lymph node metastasis were independent risk factors for DFS，but high expression of LGALS4 was a protective factor for DFS（all P<0.05）. Conclusions The expression of CK-20 and LGALS4 in papillary thyroid tissues is negatively correlated. High expression of CK-20 indicates a poor prognosis，while high expression of LGALS4 indicates a good prognosis，and both are expected to become biomarker molecules for monitoring the prognosis of papillary thyroid carcinoma.