论文部分内容阅读
目的 :检测甲状腺癌患者外周血细胞角蛋白19(cytokeratin 19,CK19)和多态性上皮黏蛋白(polymorphic epithelial mucin,MUC1)的表达以及作为外周血循环肿瘤细胞和血行微转移检测标志物的应用价值。方法 :采用流式细胞术,检测491例甲状腺癌患者以及376例结节性甲状腺肿患者外周血中CK19和MUC1阳性表达的细胞。结果 :甲状腺癌患者和结节性甲状腺肿患者的外周血CK19阳性表达率分别为35.4%(174/491)和7.7%(29/376),差异有统计学意义(P=0.000);外周血MUC1阳性表达率分别为32.8%(161/491)和3.5%(13/376),差异也有统计学意义(P=0.000)。单因素分析结果显示,肿瘤大小、包膜侵犯、淋巴结分期和远处转移均与甲状腺癌外周血CK19或MUC1阳性表达以及甲状腺癌外周血CK19和MUC1均为阳性表达显著相关(P<0.05)。多因素分析结果显示,甲状腺癌包膜侵犯、淋巴结分期和远处转移均是甲状腺癌外周血CK19阳性表达、MUC1阳性表达以及CK19和MUC1均为阳性表达的独立影响因素(P<0.05)。CK19阳性表达与MUC1阳性表达之间呈显著正相关(r=0.628,P=0.000)。结论 :甲状腺癌外周血CK19和MUC1阳性表达与甲状腺癌包膜侵犯、淋巴结分期和远处转移均密切相关,外周血CK19和MUC1检测有助于甲状腺癌血行微转移的预测及预后评估。
Objective: To investigate the expression of cytokeratin 19 (CK19) and polymorphic epithelial mucin (MUC1) in peripheral blood of patients with thyroid cancer and their clinical value as a marker of detection of peripheral blood circulating tumor cells and hematogenous micrometastasis. Methods: Flow cytometry was used to detect CK19 and MUC1 positive cells in peripheral blood of 491 thyroid cancer patients and 376 patients with nodular goiter. Results: The positive rate of CK19 in peripheral blood of patients with thyroid cancer and nodular goiter was 35.4% (174/491) and 7.7% (29/376), respectively, with statistical significance (P = 0.000); peripheral blood The positive rate of MUC1 expression was 32.8% (161/491) and 3.5% (13/376), respectively, with significant difference (P = 0.000). Univariate analysis showed that the size of tumor, invasion of envelope, lymph node metastasis and distant metastasis were positively correlated with the positive expression of CK19 or MUC1 in peripheral blood of thyroid cancer and the positive expression of CK19 and MUC1 in peripheral blood of thyroid cancer (P <0.05). Multivariate analysis showed that invasion of thyroid cancer, lymph node staging and distant metastasis were both independent factors of CK19 positive expression, MUC1 positive expression and CK19 and MUC1 positive expression in thyroid cancer peripheral blood (P <0.05). There was a significant positive correlation between CK19 positive expression and MUC1 positive expression (r = 0.628, P = 0.000). Conclusion: The positive expression of CK19 and MUC1 in thyroid carcinoma is closely related to the invasion of thyroid carcinoma, lymph node staging and distant metastasis. The detection of CK19 and MUC1 in peripheral blood is helpful for the prediction and prognosis evaluation of hematogenous micrometastasis in thyroid cancer.