摘要
目的探讨信号转导分子3(SMAD3)和白细胞分化抗原44(CD44)在甲状腺乳头状癌(PTC)组织中的表达水平与临床病理特征及预后的关系。方法选取2019年6月-2020年6月收治的PTC患者88例为研究对象,同期取距离癌组织3 cm以上癌旁组织作为对照,实时荧光定量PCR(qRT-PCR)检测SMAD3和CD44的mRNA表达水平;免疫组化法检测SMAD3和CD44的阳性表达情况。Spearman相关性分析PTC患者癌组织中SMAD3和CD44的mRNA表达水平的关系。SMAD3和CD44与PTC患者预后的关系采用Kaplan-Meier法进行分析。COX回归分析影响PTC患者预后的危险因素。结果与癌旁组织相比,PTC组SMAD3的表达水平显著降低(t=8.484,P<0.05),CD44表达水平显著升高(t=11.232,P<0.05)。相关性分析显示,PTC患者癌组织中SMAD3和CD44的mRNA表达水平呈负相关(r s=-0.519,P<0.05)。与癌旁组织相比,PTC组SMAD3阳性表达率显著降低(χ^(2)=41.905,P<0.05),CD44阳性表达率显著升高(χ^(2)=62.888,P<0.05)。SMAD3表达与TNM分期(χ^(2)=7.678,P=0.006)、淋巴结转移(χ^(2)=20.398,P<0.05)、侵犯包膜(χ^(2)=9.881,P=0.002)有关。CD44表达与TNM分期(χ^(2)=3.959,P=0.047)、淋巴结转移(χ^(2)=20.702,P<0.05)、侵犯包膜(χ^(2)=10.363,P=0.001)有关。术后随访3年发现,SMAD3阳性表达PTC患者生存率高于阴性表达患者生存率(χ^(2)=4.644,P=0.031)。CD44阳性表达PTC患者生存率显著低于阴性表达患者生存率(χ^(2)=5.331,P=0.021)。多因素COX回归分析显示,淋巴结转移、SMAD3和CD44表达是影响PTC患者预后的危险因素(P<0.05)。结论PTC组织中SMAD3呈异常低表达,CD44呈高表达,其水平与PTC患者临床病理特征及预后有关。
Objective To investigate the expression levels of signal transduction molecule 3(SMAD3)and white blood cell differentiation antigen 44(CD44)in papillary thyroid carcinoma(PTC)tissue and their relationship with clinicopathological features and prognosis.Methods A total of 88 PTC patients admitted to our hospital from June 2019 to June 2020 were selected as the study objects.The carcinoma tissue and adjacent tissue(more than 3 cm away from the carcinoma tissue)were collected and included into the PTC group and adjacent group.Real-time quantitative fluorescent polymerase chain reaction(qRT-PCR)was used to detect the mRNA expression levels of SMAD3 and CD44,and the positive expressions of SMAD3 and CD44 were detected by immunohistochemistry.Spearman correlation analysis was performed to determine the mRNA expression levels of SMAD3 and CD44 in the carcinoma tissue of PTC patients.The relationship between SMAD3 and CD44 and the prognosis of PTC patients was analyzed using the Kaplan-Meier method.COX regression was applied to analyze risk factors affecting the prognosis of PTC patients.Results Compared with the adjacent group,the expression level of SMAD3 in the PTC group was obviously reduced,while the expression level of CD44 was obviously increased(t=8.484,11.232,P<0.05).Correlation analysis showed that the mRNA expression levels of SMAD3 and CD44 in the carcinoma tissue were negatively correlated(r s=-0.519,P<0.05).Compared with the adjacent group,the positive expression rate of SMAD3 in the PTC group was obviously reduced,while the positive expression rate of CD44 was obviously increased(χ^(2)=41.905,62.888,P<0.05).The expression of SMAD3 was associated with TNM stage(χ^(2)=7.678,P=0.006),lymph node metastasis(χ^(2)=20.398,P<0.05)and invasion of envelope(χ^(2)=9.881,P=0.002).The expression of CD44 was associated with TNM stage(χ^(2)=3.959,P=0.047),lymph node metastasis(χ^(2)=20.702,P<0.05)and invasion of envelope(χ^(2)=10.363,P=0.001).After 3 years of follow-up,the survival rate of PTC patients with SMAD3 positive expression was higher than that of the patients with SMAD3 negative expression(χ^(2)=4.644,P=0.031).The survival rate of PTC patients with CD44 positive expression was significantly lower than that of those with negative expression(χ^(2)=5.331,P=0.021).Multivariate COX regression analysis showed that lymph node metastasis,SMAD3 and CD44 expression were risk factors affecting the prognosis of PTC patients(P<0.05).Conclusion The expression of SMAD3 is abnormally low and the expression of CD44 is high in PTC tissue,which is related to the clinicopathological characteristics and prognosis of PTC patients.
作者
刘延彬
左丽娟
辛运超
刘亚超
田泽东
尚小领
LIU Yanbin;ZUO Lijuan;XIN Yunchao;LIU Yachao;TIAN Zedong;SHANG Xiaoling(Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
CSCD
2024年第5期83-88,共6页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
基金
河北省医学科学研究课题计划项目(20231449)。
关键词
甲状腺乳头状癌
信号转导分子3
白细胞分化抗原44
预后
临床病理特征
Papillary thyroid carcinoma
Signal transduction molecule 3
White blood cell differentiation antigen 44
Prognosis
Clinicopathological features
