【摘要】：目的:研究β-連環(huán)素蛋白(β-catenin)、神經(jīng)細(xì)胞黏附分子(neural cell adhesion molecule,NCAM)蛋白在甲狀腺癌(thyroid carcinoma,TC)組織的表達(dá),對比分析甲狀腺癌組織與甲狀腺良性病變組織中β-catenin、NCAM蛋白的表達(dá)差異,探討β-catenin、NCAM蛋白在甲狀腺癌發(fā)生、發(fā)展中的意義,同時初步探討β-catenin、NCAM蛋白在甲狀腺癌侵襲、轉(zhuǎn)移中的作用。方法:收集臨沂市人民醫(yī)院2008年至2015年保存的甲狀腺癌組織存檔蠟塊,所有病例診斷明確,臨床資料完整,術(shù)前均未作特別治療。取70例甲狀腺癌組織和36例甲狀腺良性病變組織。用免疫組化鏈霉素抗生物素-過氧化物酶法(S-P法)聯(lián)合檢測β-catenin、NCAM蛋白在標(biāo)本中的表達(dá),探討NCAM、β-catenin表達(dá)與患者臨床病理特征的關(guān)系。應(yīng)用統(tǒng)計軟件SPSS19.0分析,采用X 2檢驗(yàn),Spearman等級相關(guān)分析,P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果:1.在甲狀腺良性病變組織中,β-catenin蛋白主要表達(dá)于細(xì)胞膜,而在甲狀腺癌組織中,β-catenin蛋白在組織胞質(zhì)或胞核異位表達(dá),在細(xì)胞膜的陽性表達(dá)率明顯低于甲狀腺良性病變組織。β-catenin在甲狀腺癌組織中的異常表達(dá)率高于甲狀腺良性病變組織(P均0.05)。甲狀腺癌各組織學(xué)類型(包括甲狀腺乳頭狀癌、甲狀腺濾泡癌、甲狀腺髓樣癌和未分化甲狀腺癌)中β-catenin異常表達(dá)率差異,經(jīng)X 2檢驗(yàn)無統(tǒng)計學(xué)意義(P0.05);甲狀腺癌組織中β-catenin蛋白異常表達(dá)率與患者的性別、年齡、腫瘤直徑、病理分期以及周圍淋巴結(jié)有無轉(zhuǎn)移均無關(guān)(P均0.05)。2.NCAM陽性表達(dá)主要位于細(xì)胞膜。NCAM在甲狀腺癌組織中的陽性表達(dá)率低于甲狀腺良性病變組織(P0.05)。甲狀腺癌各組織學(xué)類型中NCAM表達(dá)的陽性率差異,經(jīng)X 2檢驗(yàn)無統(tǒng)計學(xué)意義(P0.05);NCAM陽性率在周圍淋巴結(jié)有無轉(zhuǎn)移之間,經(jīng)X 2檢驗(yàn)差異有統(tǒng)計學(xué)意義(P0.05);甲狀腺癌組織中NCAM陽性率與患者的性別、年齡、腫瘤直徑以及病理分期均無關(guān)(P均0.05)。3.甲狀腺癌組織中NCAM的陽性表達(dá)與β-catenin異常表達(dá)經(jīng)Spearman等級相關(guān)分析,呈負(fù)相關(guān)(r=-0.025,P0.05)。結(jié)論:1.β-catenin在甲狀腺癌中存在普遍的異位表達(dá),細(xì)胞膜的表達(dá)率降低,而細(xì)胞質(zhì)或細(xì)胞核表達(dá)率增高,提示β-catenin異常表達(dá)在甲狀腺癌發(fā)生、發(fā)展中可能發(fā)揮的重要作用;2.甲狀腺癌中NCAM陽性率相對于良性甲狀腺病變顯著降低;NCAM的表達(dá)率與淋巴結(jié)轉(zhuǎn)移密切相關(guān),提示NCAM可能是甲狀腺癌轉(zhuǎn)移信號通路中發(fā)揮重要作用的分子,與甲狀腺癌侵襲轉(zhuǎn)移密切相關(guān);3.β-catenin、NCAM的檢測對于未分化甲狀腺癌與甲狀腺乳頭狀癌、甲狀腺濾泡癌、甲狀腺髓樣癌的鑒別診斷無重要價值;在鑒別甲狀腺癌與良性甲狀腺病變中,β-catenin、NCAM聯(lián)合檢測可以提高診斷的準(zhǔn)確性;4.β-catenin、NCAM兩種蛋白表達(dá)呈負(fù)相關(guān),這種反向平衡現(xiàn)象,提示NCAM、β-catenin在甲狀腺癌的發(fā)生、發(fā)展、浸潤及轉(zhuǎn)移中可能密切相關(guān)。
[Abstract]:Objective: to study the expression of 尾 -catenin (尾 -catenin) (neural cell adhesion molecule,NCAM in thyroid carcinoma (thyroid carcinoma,TC). To compare and analyze the difference of 尾-catenin,NCAM protein expression between thyroid carcinoma and benign thyroid lesions, to explore the significance of 尾-catenin,NCAM protein in the occurrence and development of thyroid carcinoma, and to explore the 尾-catenin, protein expression at the same time. Role of NCAM protein in invasion and Metastasis of thyroid carcinoma. Methods: the paraffin lumps of thyroid cancer tissue were collected from 2008 to 2015 in Linyi people's Hospital. All the cases were diagnosed clearly and the clinical data were complete. No special treatment was given before operation. 70 cases of thyroid carcinoma and 36 cases of benign thyroid lesions were collected. The expression of 尾-catenin,NCAM protein was detected by immunohistochemical streptomycin biotin-peroxidase (S-P) method, and the relationship between the expression of NCAM, 尾-catenin and the clinicopathological features of the patients was investigated. Statistical software SPSS19.0 analysis, using X 2 test, Spearman grade correlation analysis, P0.05 for the difference was statistically significant. The result is 1: 1. In benign thyroid lesions, 尾-catenin protein is mainly expressed in cell membrane, while in thyroid carcinoma, 尾-catenin protein is expressed in cytoplasm or nuclear ectopic. The positive expression rate of 尾-catenin in thyroid cancer tissues was significantly lower than that in benign thyroid lesions (P < 0. 05), and the abnormal expression rate of 尾-catenin in thyroid cancer tissues was higher than that in thyroid benign lesions (all P 0. 05). The abnormal expression rate of 尾-catenin in thyroid carcinoma tissues (including papillary thyroid carcinoma, thyroid follicular carcinoma, medullary thyroid carcinoma and undifferentiated thyroid carcinoma) showed no significant difference (P0.05). The abnormal expression rate of 尾-catenin protein in thyroid carcinoma was correlated with sex, age, tumor diameter, The positive expression of 2.NCAM was mainly located in the cell membrane. The positive expression rate of NCAM in thyroid carcinoma was lower than that in benign thyroid lesions (P0.05). There was no significant difference in the positive rate of NCAM expression among different histological types of thyroid carcinoma by X2 test (P0.05). (P0.05) the positive rate of); NCAM was significantly different between the peripheral lymph node metastasis and X2 test (P0.05). The positive rate of NCAM in thyroid carcinoma was not correlated with sex, age, tumor diameter and pathological stage (P < 0. 05). The positive expression of NCAM and the abnormal expression of 尾-catenin were negatively correlated with the expression of 尾-catenin in thyroid carcinomas by Spearman grade correlation analysis (P 0.05). Conclusion: 1. There is a general ectopic expression of 尾-catenin in thyroid carcinoma, the expression rate of cell membrane is decreased, while the expression rate of cytoplasm or nucleus is increased, suggesting that the abnormal expression of 尾-catenin is found in thyroid carcinoma. The important role that could be played in development; 2. The positive rate of NCAM in thyroid carcinoma was significantly lower than that in benign thyroid lesions. The expression rate of NCAM is closely related to lymph node metastasis, suggesting that NCAM may play an important role in the signal pathway of thyroid cancer metastasis, and is closely related to the invasion and metastasis of thyroid carcinoma. 3. The detection of 尾-catenin,NCAM has no significant value in the differential diagnosis of undifferentiated thyroid carcinoma from thyroid papillary carcinoma, thyroid follicular carcinoma and medullary thyroid carcinoma. In the differential diagnosis of thyroid carcinoma and benign thyroid disease, 尾-catenin,NCAM combined detection can improve the accuracy of diagnosis. 4. The expression of 尾-catenin,NCAM is negatively correlated with the reverse balance, suggesting that NCAM, 尾-catenin may be closely related to the occurrence, development, invasion and metastasis of thyroid carcinoma.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R736.1

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