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目的:研究分化型甲状腺癌手术联合131I清除剩余甲状腺(清甲)治疗后复发与乏氧诱导因子-1α(HIF-1α)表达的相关性,探讨HIF-1α对治疗后复发的可能机制。方法:依据甲状腺球蛋白(Tg)、甲状腺球蛋白抗体(TgAb)、B超、X线及全身131I显像的复发判定标准,观察分析173例分化型甲状腺癌手术联合131I清甲治疗成功后3年复发率,将复发病例作为复发组;随机选取相同数量未复发病例作为无复发组。采用免疫组织化学法和RT-PCR技术检测复发组和无复发组患者癌组织中HIF-1α阳性细胞率和HIF-1α基因表达水平。结果:分化型甲状腺癌手术联合131I清甲治疗成功后3年内复发率为5.20%(9/173)。其中乳头状癌复发率为4.90%(5/102),滤泡状癌复发率为5.63%(4/71),2组间比较差异无显著性(P>0.05)。复发组乳头状癌和滤泡状癌组织HIF-1α阳性细胞率和HIF-1α基因表达水平明显高于无复发组(P<0.05)。结论:分化型甲状腺癌手术联合131I清甲治疗成功后仍有少数患者复发,其机制之一可能与癌组织中HIF-1α表达水平明显增高有关。
OBJECTIVE: To investigate the correlation between the recurrence of HIF-1α (HIF-1α) and the recurrence of residual thyroid (thyroid) treated with 131I in patients with differentiated thyroid carcinoma and to explore the possible mechanism of HIF-1α recurrence after treatment. Methods: According to the criteria for the relapse of thyroid globulin (Tg), thyroglobulin antibody (TgAb), B ultrasound, X-ray and whole-body 131I imaging, 173 cases of differentiated thyroid cancer combined with 131I treatment were treated successfully Annual recurrence rate, the recurrence of cases as a recurrence group; randomly selected the same number of non-recurrent cases as no recurrence group. Immunohistochemistry and RT-PCR were used to detect the expression of HIF-1α positive cells and HIF-1α gene in the cancerous tissues of relapsed and non-relapsed patients. Results: The recurrence rate was 5.20% (9/173) within 3 years after differentiation thyroid cancer operation combined with 131I treatment. The recurrence rate of papillary carcinoma was 4.90% (5/102) and that of follicular carcinoma was 5.63% (4/71). There was no significant difference between the two groups (P> 0.05). The positive rate of HIF-1α and the expression of HIF-1α in papillary and follicular carcinoma were significantly higher in recurrence group than those in non-recurrence group (P <0.05). Conclusion: There is still a small number of patients relapse after differentiation thyroid cancer surgery combined with 131I treatment. One of the mechanisms may be related to the significant increase of HIF-1α expression in cancer tissues.