甲状腺乳头状癌的RET基因重排与PDGF-B的表达及临床病理分期的研究

【作者】 王萍；

【导师】 赵世华； 王颜刚；

【作者基本信息】 青岛大学 ， 内分泌与代谢病， 2009， 硕士

【摘要】 目的RET/PTC在甲状腺乳头状癌(PTC)中的发生率差别较大,观察青岛地区RET/PTC基因重排的发生情况;检测癌组织中血小板源性生长因子(PDGF-B)的表达,研究基因重排与PDGF-B的关系。方法采用RT-PCR方法扩增48例PTC和30例结节型甲状腺肿的新鲜组织中RET/PTC1和RET/PTC3,产物经测序证实。采用免疫组织化学方法检测肿瘤组织中PDGF-B的表达。结果48例PTC患者中发生RET/PTC者23例,重排率为47.92%,其中RET/PTC1有17例(35.42%),RET/PTC3有6例(12.5%),未检测出两种重排形式共存。30-39岁患者RET/PTC基因重排发生率最低;40-49岁患者RET/PTC基因重排发生率最高(P＜0.01)。在发生RET/PTC基因重排的肿瘤中,RET/PTC3患者的肿瘤分期明显高于RET/PTC1(P＜0.01)。肿瘤分期越高,PDGF-B的表达越强(P＜0.01),但不同RET/PTC类型中PDGF-B表达强度无明显差异(P＞0.05)。结论①甲状腺乳头状癌属于分化程度较高的肿瘤,RET/PTC基因重排见于甲状腺乳头状癌,在良性肿瘤中不表达。②青岛地区近半数PTC患者发生RET/PTC基因重排,在无放射污染的情况下,儿童及老年人群的PTC患病率低。③PDGF-B表达强度与肿瘤临床分期成正相关性。④RET/PTC基因重排与PDGF-B表达及肿瘤的临床分期无明确关联,但RET/PTC3基因重排可能影响患者预后。更多还原

【Abstract】 Objective:The frequency of RET rearrangements(RET/PTC) in papillary thyroid carcinomas(PTC) varies significantly according to geographic area.This study mainly investigated the prevalence of RET/PTC in Qingdao and the expression of plateletderived growth factor(PDGF) in order to find the relationship between these two factors.Method:Fresh tissues from 48 PTC patients and 30 nodular goiters were examined for RET rearrangements(RET/PTC1 and RET/PTC3) by means of reverse transcriptase-polymerase chain reaction(RT-PCR) analysis,followed by direct-sequence analysis.The expression of PDGF was analyzed by immunohistochemistry.Results:RET/PTC was found only in PTC.There were 23 RET/PTC positive patients in the 48 patients,with the overall frequency of RET/PTC in PTC was 47.92%,The rate of RET/PTC1 was 35.42%and 12.5%in RET/PTC3.No multiple rearrangements was present. The prevalence rate of RET/PTC was lowest among patients age 30-39y,highest among 40-49y(P＜0.01).The clinical tumor stage of RET/PTC3 was higher than RET/PTC1(P＜0.01).The level of PDGF-B expression was followed by the tumor stage (P＜0.01).There was no relationship between RET/PTC and the expression of PDGF-B (P＞0.05).Conclusions:①RET/PTC may be useful as a specific molecular marker for PTC, which was higher differentiation,but not for benign tumor.②It happened in about half of PTC in Qindao,but lower in olders and children without radiation exposure.③The expression of PDGF-B and clinical tumor stage were direct proportion.④There was no obvious relationnship between RET/PTC and the expression of PDGF-B or clinical tumor stage,but RET/PTC3 may be predict vicious result.更多还原