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目的 观察 p2 1ras蛋白、转化生长因子 (TGF)β1 和 ki- 6 7在甲状腺良恶性乳头状增生性疾病中的表达情况 ,探讨它们的表达对甲状腺乳头状癌 (PTC)发病机制的意义。 方法 采用免疫组织化学的方法对 10 3例PTC、5 7例良性乳头状增生性疾病 (包括 2 7例滤泡性腺瘤和 30例甲状腺肿组织 )进行 p2 1ras蛋白、TGFβ1 和 ki- 6 7表达的检测。 结果 (1) p2 1ras蛋白、TGFβ1 和 ki- 6 7在 PTC组中的表达显著高于滤泡性腺瘤组、甲状腺肿组及癌旁正常甲状腺组织 (P<0 .0 1)。 (2 ) PTC组中 ,p2 1ras蛋白、TGFβ1 和 ki- 6 7的表达在晚期患者、伴淋巴结转移的患者中分别显著高于早期患者、无淋巴结转移的患者 (P<0 .0 1)。 结论 在 PTC的发生、发展过程中 ,p2 1ras蛋白和 TGFβ1 的高表达起了重要的作用 ,它们共同促进 PTC的生长、浸润和转移。ki- 6 7能较可靠地反映细胞的增殖活性 ,可作为甲状腺良恶性乳头状增生性疾病的鉴别诊断及 PTC生物学行为评估的参考指标
Objective To observe the expression of p21ras protein, transforming growth factor (TGF)β1 and ki-67 in benign and malignant papillary proliferative diseases, and to explore the significance of their expression on the pathogenesis of papillary thyroid carcinoma (PTC). Methods The expression of p21ras protein, TGFβ1 and ki-67 in 103 cases of PTC and 57 cases of benign papillary proliferative diseases (including 27 follicular adenomas and 30 cases of goiter) were studied by immunohistochemistry. Detection. Results (1) The expression of p21ras protein, TGFβ1 and ki-6 in PTC group was significantly higher than follicular adenoma group, goiter group and normal thyroid tissue adjacent to cancer (P<0.01). (2) In the PTC group, the expression of p21ras protein, TGFβ1, and ki-67 was significantly higher in patients with advanced disease and lymph node metastasis, respectively, than in patients with early stage lymph node metastasis (P < 0.01). Conclusion During the occurrence and development of PTC, the high expression of p21ras protein and TGFβ1 plays an important role, which together promote the growth, infiltration and metastasis of PTC. Ki-67 can more reliably reflect the cell proliferation activity and can be used as a reference marker for the differential diagnosis of thyroid benign or malignant papillary proliferative diseases and PTC biological behavior assessment.