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目的:检测甲状腺乳头状癌(PTC)患者外周血甲状腺过氧化物酶(TPO)m RNA的表达水平,探讨其在预测PTC转移风险中的诊断价值。方法:以术后组织病理学为诊断标准,采用巢式逆转录-聚合酶链反应方法检测41例PTC患者术前外周血TPO m RNA表达阳性率,并分析其与患者临床病理学特征及转移风险的关系。结果:41例PTC患者均行全/近全甲状腺切除术联合颈部淋巴结清扫术,其中伴颈部淋巴结转移16例(39.0%),均无远处转移。将患者按照手术前血清TPO m RNA表达阳性与否分组,尽管2组间表达阳性率在性别、年龄、肿瘤最大径、肿瘤数目无显著差异(P>0.05),但伴有颈部淋巴结转移患者的表达阳性率明显高于不伴转移者(68.8%vs 36.0%,P<0.05)。对PTC患者进行术后TNM分期与复发危险度分层,TPO m RNA在不同术后分期的组间表达无显著差异(P>0.05),但在中、高危组的表达阳性率明显高于低危组(68.8%、66.7%vs 31.8%,P<0.05)。结论:外周血TPO m RNA表达水平可能有助于预测PTC转移的风险,有望成为甲状腺癌的分子标志物。
Objective: To detect the expression of thyroid peroxidase (TPO) m RNA in the peripheral blood of patients with thyroid papillary carcinoma (PTC) and to evaluate its diagnostic value in predicting the risk of PTC metastasis. Methods: The postoperative histopathology was used as diagnostic criteria. The positive rate of TPO m RNA expression in peripheral blood of 41 patients with PTC was detected by nested reverse transcription - polymerase chain reaction (PCR - RT - PCR). The clinicopathological features and metastasis The relationship between risk. Results: All 41 patients underwent total / near total thyroidectomy combined with cervical lymph node dissection. Among them, 16 cases (39.0%) had neck lymph node metastasis without any distant metastasis. The patients were divided into groups according to the positive expression of serum TPO m RNA before surgery. Although there was no significant difference (P> 0.05) in the gender, age, maximum diameter of tumor and the number of tumor, the positive rate of TPO m RNA in the two groups was significantly higher than that in patients with cervical lymph node metastasis (68.8% vs 36.0%, P <0.05). There was no significant difference in the expression of TPO m RNA between the two groups (P> 0.05). However, the positive rates of TPO m RNA in middle and high risk group were significantly higher than those in low risk group At risk group (68.8%, 66.7% vs 31.8%, P <0.05). Conclusion: The expression level of TPO m RNA in peripheral blood may help predict the risk of PTC metastasis and is expected to become a molecular marker of thyroid cancer.