摘要
目的探讨β-连环素蛋白预测分化型甲状腺癌转移的临床价值。方法选取2013年2月至2019年10月华中科技大学协和深圳医院收治的423例分化型甲状腺癌患者,其中男123例,女300例;组织学类型:乳头状癌297例,滤泡癌126例;TNM分期:Ⅰ~Ⅱ期232例,Ⅲ~Ⅳ期191例,根据术后组织病理结果,将患者分为转移组(73例)和未转移组(350例)。免疫组化法检测癌组织中β-连环素蛋白表达情况,比较两组患者的临床病理参数及β-连环素蛋白评分,应用ROC曲线分析β-连环素蛋白评分预测分化型甲状腺癌转移的临床价值,应用多因素Logistic回归分析分化型甲状腺癌转移的影响因素。结果β-连环素蛋白在癌组织中主要表达于细胞膜上。转移组的β-连环素蛋白半定量评分明显高于未转移组[(6.61±1.82)分vs.(3.60±1.11)分],差异有统计学意义(t=13.612,P<0.001);且两组患者的年龄、肿瘤直径、病灶位置及TNM分期等差异有统计学意义(P<0.05)。β-连环素蛋白表达与肿瘤直径、TNM分期及腺外侵犯相关(P<0.05),与性别、年龄、组织学类型及病灶位置等无关(P>0.05)。根据ROC曲线,β-连环素蛋白评分诊断分化型甲状腺癌转移的最佳临界值为4.08分,敏感度为65.75%,特异度为69.43%,ROC曲线下面积(AUC)为0.708(95%CI:0.645~0.772),具有一定的预测价值。Logistic回归分析结果显示,β-连环素蛋白评分>4.08分(OR=1.824,95%CI:1.315~2.530)、TNM分期Ⅲ~Ⅳ期(OR=1.735,95%CI:1.105~2.723)及肿瘤直径>1.0 cm(OR=1.523,95%CI:1.207~1.924)是分化型甲状腺癌转移的独立危险因素(P<0.05)。结论β-连环素蛋白在分化型甲状腺癌中异常表达,对预测甲状腺癌转移有一定的临床价值。
Objective To explore the value ofβ-catenin in predicting metastasis of differentiated thyroid carcinoma.Methods 423 patients with differentiated thyroid cancer treated in huazhong university of science and technology union shenzhen hospital from February 2013 to October 2019 were selected as the subjects,according to the pathological results,the patients were divided into two groups:metastasis group(n=73)and non-metastasis group(n=350).The expression ofβ-catenin protein was detected by immunohistochemical method,and the semi-quantitative score ofβ-catenin protein was compared between the two groups.ROC curve and multivariate logistic regression model were used to explore the clinical value ofβ-catenin protein in predicting the metastasis of differentiated thyroid carcinoma.Results The results of immunohistochemistry showed thatβ-catenin was mainly expressed on the cell membrane in cancer tissues.The expression ofβ-catenin protein was correlated with tumor diameter,TNM stage and extraglandular invasion(P<0.05),but not with gender,age,histological type and lesion location(P>0.05).The semi-quantitative score ofβ-catenin in metastasis group was significantly higher than that in non-metastasis group[(6.61±1.82)vs.(3.60±1.11),P<0.001)].According to the ROC curve,the diagnostic critical value ofβ-catenin is 4.08 score,the corresponding sensitivity is 65.75%,and the specificity is 69.43%,and the AUC is 0.708(95%CI:0.645-0.772),which had a certain predictive value.There were significant differences in age,tumor diameter,lesion location and TNM stage between the two groups(P<0.05).Logistic regression analysis showed that the semi-quantitative score ofβ-catenin(OR=1.824,95%CI:1.315-2.530),TNM stage(OR=1.735,95%CI:1.105-2.723)and tumor diameter(OR=1.523,95%CI:1.207-1.924)were independent risk factors of advanced DTC metastasis(P<0.05).Conclusions The abnormal expression ofβ-catenin in differentiated thyroid carcinoma had a certain predictive value in predicting the metastasis of thyroid carcinoma,which is worthy of further clinical research and promotion.
作者
冯铎
徐菲
刘尧
邹天辉
王寰昱
邹家威
FENG Duo;XU Fei;LIU Yao;ZOU Tianhui;WANG Huanyu;ZOU Jiawei(Department of Thyroid and Breast Surgery, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen 518052, China)
出处
《中国肿瘤外科杂志》
CAS
2021年第3期296-300,共5页
Chinese Journal of Surgical Oncology
