摘要
目的探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)生长模式与肿瘤临床病理特征的相关性,并分析整合素β4的表达水平与PTC生长模式间的关系。方法 59例经典型PTC依据其生长模式,分为膨胀型、局部浸润型及弥漫浸润型3组;分析其与肿瘤大小、腺外浸润、淋巴结转移及BRAFV600E突变等因素的关系;免疫组化半定量评价3组间整合素β4的表达状况。结果 (1)经典型PTC中,局部浸润型模式最常见(64%,38/59),弥漫浸润型次之(24%,14/59),膨胀型少见(12%,7/59)。(2)PTC浸润性生长模式与肿瘤腺外浸润密切相关(χ2=12.58,P<0.05)。弥漫浸润型腺外浸润的比例最高(93%,13/14),局部浸润型居中(57%,20/35),膨胀型少见(14%,1/7)。(3)整合素β4表达水平与PTC生长模式(F=20.07,P<0.05)及腺外浸润(t=2.57,P<0.05)均密切相关。β4在弥漫浸润型和局部浸润型外周区的表达高于膨胀型(P<0.05)与局部浸润型中心区(P<0.05);膨胀型与局部浸润型中心区相比,β4表达无差异(P>0.05)。(4)与3种生长模式相对应的淋巴结转移灶内的癌组织,彼此间β4的表达水平差异无显著(χ2=0.344,P>0.05)。转移性肿瘤组织β4的表达强度与膨胀型及局部浸润型中心区的水平相当,但明显低于弥漫浸润型与局部浸润型外周区的水平。结论 (1)PTC浸润性生长方式与肿瘤的高腺外浸润密切相关,特别是弥漫浸润型PTC,具有更强的腺外侵袭性。建议病理报告中列入PTC生长模式的描述,以提示其生物学行为。(2)整合素β4高表达参与/介导了PTC的间质浸润,并可能是衔接肿瘤浸润性生长模式与高侵袭生物行为间的重要分子机制。(3)PTC生长模式与肿瘤大小、临床分期、淋巴结转移及BRAFV600E突变等因素无统计学相关。
Purpose To elucidate the correlations of growth pattern in papillary thyroid carcinoma（PTC） with the clinicopathological parameters and the expression status of integrin β4.Methods 59 cases of classical PTC were subdivided into three groups： the bulking growth pattern,the focally invasive pattern and the extensively invasive pattern,based on the morphologic characteristics of stromal invasion.The relationships between growth patterns and tumor sizes,extra-thyroid invasion,lymph node metastasis as well as BRAFV600E mutation were analyzed.Furthermore,the expressional profiles of integrin β4 were detected by immunohistochemistry.Results Focally invasive PTC was of the most-commonly encountered growth pattern（64%,38/59）and subsequently followed by extensively invasive pattern（24%,14/59） and bulking pattern（12%,7/59）.Invasive growth pattern was positively correlated to extra-thyroid invasion（χ2=12.58,P〈0.05） in which 93%（13/14） cases of the extensively invasive PTC and 57%（20/35） cases of the focally invasive PTC showed extra-thyroid invasion,while only 14%（1/7） cases of bulking growth related PTC manifested the same behavior.The expressional profiles of β4 statistically correlated to growth pattern of PTC（F=20.07,P〈0.05） and also to extra-thyroid invasion（t=2.57,P〈0.05）.The β4 expression was obviously higher in extensively invasive pattern as well as the invasive margin of focally invasive pattern,as comparied with the bulking pattern and the central region of focally invasive pattern（P〈0.05）.No differences of β4 expression were found between bulking growth pattern and the central region of focally invasive pattern（P〈0.05）.In addition,β4 expression showed no differences in lymph node metastasizing foci among the three growth patterns（χ^2=0.344,P〈0.05）.The intensity of β4 expression in lymph node metastasizing foci was statistically equivalent to that of bulking pattern and the central region of focally invasive pattern in the primary lesion,bu
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2012年第10期1127-1132,共6页
Chinese Journal of Clinical and Experimental Pathology
基金
深圳市科技局立项资助(201002002)
