【摘要】 目的探讨中期因子(MK)和核转录因子Kappa B(NF-κB)免疫组化测定对甲状腺乳头状癌(PTC)及转移灶的诊断价值。方法选取2016年3月至2018年5月间北京市大兴区人民医院收治的70例行甲状腺全切除术的PTC患者,及行单侧腺叶切除或双叶大部切除的65例多发性结节性甲状腺肿(MNG)患者。根据是否有转移灶进一步分为PTC1组(有转移灶)和PTC2组(无转移灶),汇总和记录患者的病例资料,采用免疫组化染色法检测各组组织中MK、NF-κB p65和Ki-67的表达,计算并绘制三个指标的灵敏度、特异度、最大约登指数、曲线下面积和受试者工作特征(ROC)曲线,通过Western印迹测定证实免疫组化结果。结果 PTC患者术后组织MK、NF-κB和Ki-67的表达明显高于MNG患者,差异均有统计学意义(均P <0. 05); ROC结果显示三个指标对PTC的诊断效能较好,最大约登指数分别为0. 871、0. 816和0. 771。PTC亚组1病例的三个指标表达明显高于PTC亚组2病例,差异均有统计学意义(均P <0. 05); ROC结果显示三个指标对PTC转移灶的诊断效能较好,最大约登指数分别为0. 835、0. 684和0. 870;三组患者MK和NF-κB的蛋白水平比较,组间差异有统计学意义(均P <0. 05)。结论 MK和NF-κB对PTC的诊断效能较好,敏感度和特异度较高,并且MK和NF-κB对PTC患者手术时是否存在转移灶的判断具有一定的价值。更多还原

【Abstract】 Objective To study the diagnostic value of immunohistochemical detection of Midkine( MK) and nuclear transcription factor Kappa B( NF-κB) for papillary thyroid carcinoma( PTC) and metastasis. Methods Seventy patients undergoing hysterectomy for PTC and 65 patients undergoing unilateral lobectomy or double lobectomy for multiple nodular goiter( MNG) at Beijing Daxing District People’s Hospital from March 2016 to May 2018 were selected. According to whether there were metastases,they were further divided into group PTC1( metastasis) and group PTC2( without metastasis). The clinical and pathological data of the patients were collected and recorded. Immunohistochemical staining was used to detect the expression of MK,NF-κB p65 and Ki-67 in the tissues of each group. The sensitivity,specificity,maximum Jordan index,the area under the curve and the receiver operating characteristic( ROC) curve of three indexes were calculated and plotted. The results of immunohistochemistry were confirmed by Western blot.Results The expression of MK,NF-κB and Ki-67 was significantly higher in PTC patients than that in MNG patients( all P < 0. 05). The ROC results showed that the three indexes had better diagnostic efficiency for PTC,and the largest Jordan index was 0. 871,0. 816 and 0. 771,respectively. The expression of three indexes in PTC subgroup 1 was significantly higher than in PTC subgroup 2( all P < 0. 05). The results of ROC showed that the three indexes were effective in diagnosing PTC metastases,and the maximum Jordan index was 0. 835,0. 684 and 0. 870,respectively. The protein levels of MK and NF-κB in the three groups were statistically significant( all P < 0. 05). Conclusion The diagnostic efficiency of MK and NF-κB is good,and the sensitivity and specificity are high,and the two indexes are of certain value for the diagnosis of metastasis during the surgery for PTC.更多还原