细胞角蛋白-19 波形蛋白血管内皮生长因子-C和环氧化物酶-2 在甲状腺乳头状癌和滤泡癌中的表达及意义

目的:探讨细胞角蛋白-19（CK- 19）、波形蛋白（Vimentin）、血管内皮生长因子-C（VEGF-C）和环氧化物酶-2（COX-2）表达与甲状腺乳头状癌和滤泡癌分化、浸润、转移的关系。方法:采用免疫组织化学SP法检测94例乳头状癌和54例滤泡癌中CK- 19、Vimentin、VEGF-C、COX-2 的表达。结果:CK- 19、VEGF-C、COX-2 表达于癌细胞的胞浆，Vimentin 在癌组织的间质和癌细胞的胞浆均有表达，其表达差异从阳性率和阳性强度两个方面予以统计分析。乳头状癌中CK- 19表达的阳性率（90.4%）高于滤泡癌（61.1%），Vimentin、VEGF-C 和COX-2 表达的阳性率（100% 、86.2% 、81.9%）近似于滤泡癌（100% 、87.0% 、81.5%）。 乳头状癌无转移组和有转移组（含原发灶和转移灶）四种指标的阳性率均相近，滤泡癌高分化型组与低分化型组相比，除Vimentin 的阳性率均为100% 外，其他三种指标CK- 19、VEGF-C、COX-2 均为高分化型组阳性率（74.1% 、88.9% 和85.2%），高于低分化型组阳性率（48.1%、85.2%和77.8%）。 Vimentin 和VEGF-C 的免疫阳性表达强度在乳头状癌中高于滤泡癌，CK- 19和COX-2 在乳头状癌和滤泡癌中的表达相近。四种免疫学指标的免疫阳性强度在乳头状癌原发灶、转移灶、滤泡癌高分化组、低分化型组间均无明显差异。乳头状癌中CK- 19与Vimentin 间免疫表达强度无相关性，VEGF-C 和COX-2 间呈正相关关系。结论:综合检测CK- 19、Vimentin、VEGF-C 和COX-2 四种免疫学指标，对探讨甲状腺乳头状癌和滤泡癌分化、浸润、转移和预后评估具有一定的参考价值。 

Expression and Significance of Cytokeratin-19,Vimentin,Vascular Endothelial Growth Factor-C and Cyclooxygenase-2 in Papillary Carcinoma and Follicular Carcinoma of Thyroid

Objective:To study the correlations among the expression levels of cytokeratin-19(CK-19), vimentin, vascu -lar endothelial growth factor-C (VEGF-C) and cyclooxygenase- 2 (COX- 2) and the differentiation, invasiveness and meta -static potential in papillary and follicular thyroid carcinomas (FTC). Methods: Immunohistochemical SP method was used to assess the expression of CK-19, vimentin, VEGF-C and COX- 2 in the 94cases of papillary thyroid carcinoma (PTC) and 54cases of FTC enrolled in our study. Results: CK-19, VEGF-C and COX- 2 were expressed in the cytoplasm of tumor cells. Vimentin was expressed both in the mesenchyma and in the cytoplasm of tumor cells. Differences in expression were analyzed statistically using the positive rate and expression intensity. The positive rate of CK- 19was significantly higher in PTC ( 90.4%) than in FTC (61.1%). The positive rates of vimentin, VEGF-C and COX-2 in PTC ( 100 %,86.2% and 81.9%, respectively) were similar to those in FTC ( 100 % ,87.0% and 81.5% , respectively). The expression rates of the four pro-teins in PTC with and without lymph node metastasis (including the primary foci and metastatic lesions) were also similar to each other. Except for the positive rates of vimentin expression, both 100 % in the two differentiation types of FTC, the ex-pression rates of CK- 19, VEGF-C and COX- 2 were higher in well-differentiated FTC ( 74.1% ,88.9% and 85.2% ) than in poorly differentiated FTC ( 48.1%,85.2% and 77.8%). The expression intensities of vimentin and VEGF-C in PTC were sig-nificantly higher than those in FTC. The expression intensities of CK-19and COX-2 in PTC were similar to those in FTC. No significant difference was found in PTC between cases with and without metastasis, and no significant difference was found in FTC between the well-differentiated cases and the poorly differentiated cases. There is a positive correlation be -tween the expression intensity of VEGF-C and COX- 2 in PTC, but not between the expression of CK- 19and vimentin. Conclusion : Immunohistochemical detection of CK- 19, vimentin, VEGF-C and COX-2 expression may carry clinical signifi-cance in evaluating the degree of differentiation, invasiveness, metastatic potential, and prognosis of papillary thyroid carcinoma and follicular thyroid carcinoma.