摘要
目的观察分化型甲状腺癌患者原发灶与颈部淋巴结转移灶雌激素受体(Estrogen receptor,ER)、孕激素受体(Progesterone receptor,PR)和人表皮生长因子受体2(Human epidermal growth factor receptor 2,HER-2)的表达情况。比较原发灶与淋巴结转移灶表达的一致性,探讨其临床价值。方法选取2017年1月~2021年3月于南通市第六人民医院行单侧甲状腺癌根治术及淋巴结清扫的患者183例。对原发灶及淋巴结进行免疫组织化学检测,比较原发灶与淋巴结中ER、PR、HER-2表达情况,计算不一致率。分析ER、PR、HER-2表达不一致与性别、年龄和甲状腺癌分期的关系。结果183例患者中73例出现淋巴结转移。原发灶中ER阳性表达率56.16%(41/73),10例原发灶阳性淋巴结阴性,8例原发灶阴性转为淋巴结阳性,共18例在原发灶和淋巴结转移灶表达不一致,不一致率24.65%(18/73)。原发灶和淋巴结表达的差异有统计学意义(χ^(2)=18.313,P=0.000)。原发灶中PR阳性9例淋巴结阴性,7例在原发灶PR为阴性患者淋巴结阳性,16例在原发灶和淋巴结转移灶表达不一致,不一致率21.91%(16/73)。原发灶和淋巴结表达的差异有统计学意义(χ^(2)=15.793,P=0.000)。共11例HER-2在原发灶和淋巴结转移灶表达不一致,不一致率15.07%(11/73)。原发灶和淋巴结表达的差异有统计学意义(χ^(2)=9.831,P=0.002)。在淋巴结中HER-2阳性率高于原发灶,但组间差异无统计学意义(P>0.05)。年龄<55岁患者ER、HER-2不一致率明显高于年龄≥55岁者,差异有统计学意义(P<0.05)。Ⅲ~Ⅳ期患者HER-2不一致率高于Ⅰ~Ⅱ期,差异有统计学意义(P<0.01)。结论分化型甲状腺癌患者原发灶、淋巴结转移灶的ER、PR、HER-2表达存在着不一致性。不一致性与患者年龄和临床分期有关。
Objective To investigate the expression of estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER-2)in primary and cervical lymph node metastases of differentiated thyroid carcinoma.To compare the expression consistency between primary tumor and lymph node metastasis,and to explore its clinical value.Methods Patients with unilateral radical thyroidectomy and lymph node dissection were selected.The primary lesions and lymph nodes were detected by immunohistochemistry.The expression of Er,PR and HER-2 in primary tumor and lymph node were compared,and the inconsistency rate was calculated.The relationship between the expression of Er,PR and HER-2 and gender,age and thyroid cancer stage was analyzed.Results Of the 183 patients,73 had lymph node metastasis.The positive expression rate of ER was 56.16%(41/73)in primary lesions,10 cases of positive lymph nodes in primary lesions were negative,and 8 cases of negative primary lesions turned to positive lymph nodes.A total of 18 cases had inconsistent expression in primary lesions and lymph node metastases,and the inconsistent rate was 24.65%(18/73).There was significant difference in the expression of ER in primary tumor and lymph node,χ^(2)=8.313,P=0.000.Among the primary lesions,9 cases were PR positive,7 cases were PR negative,and 16 cases were inconsistent between the primary lesions and lymph node metastases,with the inconsistency rate of 21.91%(16/73).There was significant difference in the expression of PR in primary tumor and lymph node,χ^(2)=15.793,P=0.000.The expression of HER-2 was inconsistent in 11 cases(15.07%).There was significant difference in the expression of HER-2 in primary tumor and lymph node,χ^(2)=9.831,P=0.002.The positive rate of HER-2 in lymph nodes was higher than that in primary lesions,but the difference was not statistically significant(P>0.05).The inconsistency rate of ER and HER-2 in patients aged<55 years old was significantly higher than that in patients aged≥55 years old(P<0.05).The inconsis
作者
王琪
尹中波
佘丽丽
孙梓程
陈海军
刘岩
Wang Qi;Yin Zhongbo;She Lili(Depatment of Pathology,the Sixth People's Hospital of Nantong Affiliated Nantong Hospital of Shanghai University,Nantong 226000,China)
出处
《中华保健医学杂志》
2021年第6期630-633,共4页
Chinese Journal of Health Care and Medicine
基金
南通市科技计划项目(MSZ20002)。
关键词
分化型甲状腺癌
原发灶
淋巴结
人表皮生长因子受体2
Differentiated thyroid carcinoma
Primary tumor
Lymph node
Human epidermal growth factor receptor 2
