【摘要】 目的研究转移相关基因CD44v6在甲状腺癌中表达及临床应用。方法采用9号细针穿刺甲状腺癌标本43例,抽取组织细胞及术后石蜡切片组织,均行免疫组化S-P方法测定43例甲状腺癌组织中的CD44v6表达阳性率,分析其阳性率与临床应用情况,以及细胞学检测和石蜡切片比较。结果细胞学检测阳性表达21例,淋巴结转移组CD44v6表达阳性率53.8%,非淋巴结转移组为46.7%;Ⅰ期CD44v6阳性表达率42.9%,Ⅱ期52.9%,Ⅲ期100.0%。而石蜡切片阳性结果27例,淋巴结转移组CD44v6表达阳性率84.6%,非淋巴结转移组为53.3%;Ⅰ期CD44v6阳性表达率为66.7%,Ⅱ期76.5%,Ⅲ期100.0%,分期越高,表达阳性率越高。另外甲状腺乳头状腺癌细胞学检测CD44v6阳性表达率52.0%,石蜡切片阳性率72.0%,高于其他类型,与其易发生颈淋巴结转移的生物学特性是一致的,而在分化差的髓样癌中无表达,说明CD44v6表达阳性率与病理分型有关。结论细针穿刺细胞学检测转移相关基因CD44v6测定方法是可靠的,若结合石蜡切片,阳性率会更高。CD44v6表达与甲状腺癌的颈淋巴结转移、临床分期、病理类型等有一定关系,可以作为判断预后及颈清扫的依据。更多还原

【Abstract】 Objective To study the expression of metastasis-associated gene CD44v6 in differentiated thyroid cancers and clinical application.Methods By puncturing 43 thyroid cancers with No.9 fine needle,the histiocytes aspirated and the histiocytes in paraffin,section of the cancers after operation were examined for the expression of CD44v6 using SP method.The positive rate and the clinical application were analyzed and the cytology examination and histiocytes in paraffin section were compared.Results The positive result in cytology examination was obtained in 21 cases,of which the positive expression rate of CD44v6 in lymph node metastasis group was 53.8% and in non-lymph-node metastasis group was 46.7%.The positive expression rates of CD44v6 in different clinical stages were 42.9% in stage Ⅰ,52.9% in stage Ⅱ,100.0% in stage Ⅲ.The positive result in histiocytes of paraffin sections was obtained in 27 cases,of which the positive expression rate of CD44v6 in lymph node metastasis group was 84.6% and in non-lymph-node metastasis group was 53.3%;The positive expression rate of CD44v6 in different clinical stages were 66.7% in stage Ⅰ,76.5% in stage Ⅱ and 100.0% in stage Ⅲ.Therefore,it could be considered that the higher the clinical stage,the higher the positive expression rate of CD44v6.Besides,the positive expression rate of CD44v6 in the papillary adenocarcinoma of thyroid was 52.0% in the cytology examination and 72.0% in the histiocytes of paraffin section,which were higher than other types,but the biological features of causing the lymph node metastasis were the same.No expression of CD44v6 was seen in poorly differentiated medullary carcinoma.Therefore,the positive expression rate of CD44v6 was related to the type of pathology.Conclusions The method of puncturing with fine needle is reliable,if combined with the paraffin section,the positive rate will increase.The expression of CD44v6 is related to the cervical lymph node metastasis of thyroid cancers,the clinical stage and the type of pathology,which can be used as the basis for judging the prognosis and radical neck dissection.更多还原