Ezrin蛋白在甲状腺乳头状癌中的表达及其与生存期关系的研究

目的探讨膜细胞骨架链接蛋白Ezrin在甲状腺乳头状癌组织中的表达及其与生存期关系的研究。方法收集武汉大学人民医院和武汉大学中南医院病理2000-2006年手术切除及活检的甲状腺乳头状癌标本40例和甲状腺腺瘤标本20例。采用免疫组织化学方法检测各组组织内Ezrin蛋白的表达。利用HPIAS-2000图像分析系统测定Ezrin蛋白在甲状腺乳头状癌及甲状腺腺瘤中表达的平均光密度和平均阳性面积率,并结合临床资料进行总生存期分析。结果 1.甲状腺乳头状癌组织中Ezrin蛋白呈高表达;甲状腺腺瘤中Ezrin蛋白呈低表达;图像分析结果显示两组间差异有显著性意义(P<0.05)。2.Ezrin蛋白表达强阳性组总生存期均短于表达弱阳性组(P<0.05),差异有统计学意义。结论 Ezrin蛋白与甲状腺乳头状癌的发生、发展及临床预后有密切关系。     

COX-2和IL-1在甲状腺乳头状癌组织中的表达

目的探讨COX-2和IL-1在甲状腺乳头状癌组织中的表达及其在肿瘤的发生和发展中的作用。方法收集武汉大学人民医院和武汉大学中南医院病理科2000-2006年手术切除及活检的甲状腺乳头状癌标本共40例,另取癌周围组织5例作对照。采用免疫组织化学方法观察各组组织内COX-2和IL-1的表达。利用HPIAS-2000图像分析系统测定COX-2和IL-1在癌及癌旁组中表达的平均光密度和平均阳性面积率。结果甲状腺乳头状癌组织中COX-2和IL-1呈高表达;癌旁组织中COX-2和IL-1呈低表达。图像分析结果显示两组间差异有显著性意义（P〈0.01）。结论IL-1可能通过诱导COX-2的表达,在促进肿瘤的发生和发展中起作用。     

CBX7蛋白在甲状腺乳头状癌中的表达及意义

目的探讨CBX7蛋白在甲状腺乳头状癌组织中的表达及其临床意义。方法收集江夏区人民医院病理科2009-2013年手术切除及活检的甲状腺乳头状癌标本40例和癌旁组织标本20例。采用免疫组织化学方法检测各组组织中CBX7蛋白的表达。并对各组免疫组织化学反应的平均光密度和平均阳性面积率做单因素方差分析和SNK(q)检验,检验水准α为0.05。结果 CBX7蛋白在癌旁组织中呈高表达,甲状腺乳头状癌中呈低表达,统计分析显示,CBX7蛋白在癌旁组织中的表达显著高于甲状腺乳头状癌(P0.05)。结论 CBX7蛋白在甲状腺乳头状癌中呈低表达,可能与甲状腺乳头状癌的发生和发展密切相关。     

DcR3在甲状腺乳头状癌中的表达及临床意义

应用RT-PCR、Westem blot、免疫组化分别检测甲状腺乳头状癌组织与癌旁正常甲状腺组织标本中DcR3mRNA及蛋白的表达情况,探讨DcR3在甲状腺乳头状癌组织中的表达及,临床意义。RT-PCR检测显示,甲状腺乳头状癌中DcR3 mRNA的表达明显高于正常甲状腺组织（P〈0．05）：Western blot提示,DcR3蛋白在甲状腺乳头状癌中表达比正常甲状腺组织高（P〈0．05）;免疫组化显示,DcR3蛋白在甲状腺乳头状癌中高表达（P〈0．05）。DcR3mRNA及蛋白质在甲状腺乳头状癌及正常甲状腺组织间的表达差异有统计学意义（P〈0．05）。DcR3基因及蛋白在甲状腺乳头状癌中高表达,提示DcR3可能促进了甲状腺乳头状癌的发生发展。     

Cox-2和Suvrivin蛋白在眼睑基底细胞癌组织中的表达

目的探讨Cox-2和Suvrivin蛋白在眼睑基底细胞癌组织中的表达及临床意义。方法收集武汉大学人民医院和武汉大学中南医院病理科1999-2006年手术切除及活检的眼睑基底细胞癌（basal cell carcinoma,BCC）标本共40例,另取癌周围组织5例作对照。眼睑基底细胞癌发病年龄20-68岁。采用免疫组织化学方法观察各组细胞内Cox-2和Suvrivin蛋白表达的变化。利用HPIAS-2000图像分析系统测定Cox-2和Suvrivin蛋白在以上各组中表达的平均光密度和平均阳性面积率。结果眼睑基底细胞癌组织中COX-2蛋白呈高表达;癌旁组织中COX-2蛋白呈低表达。眼睑基底细胞癌组织中Suvrivin蛋白呈高表达;癌旁组织中Suvrivin蛋白呈低表达。图像分析结果显示：眼睑基底细胞癌组织与癌旁组织之间COX-2和Suvrivin蛋白的平均光密度及阳性面积率的差异有显著性意义（P〈0.01）。结论COX-2、Survivin在眼睑BCC中的异常表达,对眼睑BCC的发生和发展起了重要作用。     

PSCA和Oct-4蛋白在眼睑基底细胞癌组织中的表达及其意义

目的 探讨PSCA和Oct-4蛋白在眼睑基底细胞癌组织中的表达及其意义.方法 收集武汉市中心医院和武汉大学人民医院病理科2002～2009年手术切除及活检的眼睑基底细胞癌（basal cell carcinoma,BCC）标本共20例,另取癌周围组织5例作对照.采用免疫组织化学方法观察各组细胞内PSCA和Oct-4蛋白的表达.利用图像分析系统测定PSCA和Oct-4蛋白在以上各组中表达的平均光密度和平均阳性面积率.结果 （1）PSCA的表达在眼睑基底细胞癌中,PSCA呈高表达,而癌周围组织中PSCA呈低表达.经q 检验,眼睑基底细胞癌组织与癌旁组织之间PSCA的平均光密度及阳性面积率的差异有显著性意义（P〈0.05）.（2）Oct-4的表达眼睑基底细胞癌组织中Oct-4蛋白呈高表达;癌旁组织中Oct-4蛋白呈低表达.图像分析结果显示：眼睑基底细胞癌组织与癌旁组织之间Oct-4蛋白的平均光密度及阳性面积率的差异有显著性意义（P〈0.05）.结论 在眼睑基底细胞癌组织中PSCA和Oct-4蛋白的高表达可能是＂癌干细胞＂,PSCA和Oct-4蛋白也许参与了眼睑基底细胞癌的发生和发展.     

Notch-1信号通路与甲状腺乳头状癌的关系

研究Notch-1信号通路中Notch-1、NICD、Hes1、c-Myc与人甲状腺乳头状癌的关系,探讨Notch-1信号通路在甲状腺乳头状癌中的分子机制。对照人甲状腺乳头状癌及正常甲状腺组织标本各35例,采用Real Time PCR检测Notch-1、Hes1、c-Myc的mRNA表达情况,采用免疫组织化学、Western blot方法检测组织标本中Notch-1、NICD、Hes1、c-Myc蛋白的表达情况。Notch-1、Hes1在甲状腺乳头状癌中的mRNA表达水平明显降低,c-Myc mRNA的表达在甲状腺乳头状癌中升高,Notch-1、NICD、Hes1蛋白在人甲状腺乳头状癌中的表达低于正常甲状腺组织（P〈0.05）,c-Myc蛋白在甲状腺乳头状癌中的表达高于正常甲状腺组织（P〈0.05）。甲状腺乳头状癌组织标本中,Notch-1信号通路中Notch-1、NICD、Hes1在基因转录和蛋白质表达水平上均明显下调,而c-Myc的基因转录和蛋白质表达水平均升高,提示Notch-1信号通路在甲状腺乳头状癌的发生发展中起抑癌作用,c-Myc基因表达升高与Notch-1信号通路可能无关。     

瘦素及其受体在甲状腺乳头状癌组织中共同高表达

目的探讨瘦素(leptin)和瘦素受体(leptin recptor,LEPR)在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)组织中的表达及其临床意义。方法采用免疫组织化学Elivision法分别检测60例甲状腺乳头状癌组织和45例甲状腺腺瘤组织中leptin和LEPR的表达,免疫荧光双染检测leptin及LEPR在甲状腺乳头状癌组织和癌旁正常甲状腺组织中的共同表达;Pearson相关性分析法分析PTC组织中leptin和LEPR表达水平之间的相关性,卡方检验法分析leptin和LEPR表达与患者临床病理特征之间的关系。结果 Leptin和LEPR在PTC组织中的阳性表达率均高于甲状腺腺瘤组织;二者在PTC组织中的表达呈正相关,并呈共同高表达;在PTC组织中,肿瘤直径≥1cm者leptin和LEPR阳性表达率均高于肿瘤直径1cm者;leptin和LEPR在有淋巴结转移者阳性表达率均低于未发生转移者。结论 leptin和LEPR在PTC组织中呈现共同高表达,且两者的表达与肿瘤直径和淋巴结转移等肿瘤进展指标密切相关,提示两者可能在PTC的发生、发展中发挥重要作用,可以作为PTC治疗的潜在靶点。     

甲状腺肿瘤组织VEGF-C和ERβ的表达与LVD的相关性分析

目的:探讨甲状腺肿瘤和癌旁正常甲状腺组织中VEGF-C和ERβ的表达与组织平均淋巴管密度的相关性.方法:采用SP免疫组织化学染色检测116例甲状腺癌、56例甲状腺腺瘤和20例正常甲状腺组织中VEGF-C和ERβ及D2-40的表达;以D2-40阳性结果计算组织平均淋巴管密度(LVD).观察不同甲状腺组织中VEGF-C和ERβ的表达水平并分析其与LVD的相关性.结果:甲状腺癌组织中VEGF-C的高表达阳性率显著高于正常甲状腺和甲状腺腺瘤(P＜0.05),ERβ的高表达阳性率显著低于正常甲状腺和甲状腺腺瘤(P＜0.05);两者表达呈轻度负相关(r=-0.312,P＜0.01);甲状腺癌VEGF-C表达与淋巴结转移和TNM分期有关(P＜0.01).用D2-40标记的LVD值在甲状腺癌、甲状腺腺瘤和正常甲状腺组织之间有显著性差异(P＜0.001).甲状腺癌中淋巴结转移组LVD显著高于无淋巴结转移组(P＜0.0001).VEGF-C表达与D2-40呈正相关(r=0.515,P＜0.01).结论:ERβ表达下调可能通过促进VEGF-C的表达,进而影响淋巴管增生,促进肿瘤淋巴道转移.     

HSP70 和P53 蛋白在甲状腺乳头状癌中的表达 及其与临床病理特征的关系

目的:探讨热休克蛋白70(HSP70)和P53蛋白在甲状腺乳头状癌组织中的表达及其与临床病理特征的关系。方法:应用免疫组织化学Envision法检测35例甲状腺乳头状癌组织、15例甲状腺良性病变组织及15例正常甲状腺组织中HSP70和P53蛋白的表达,分析HSP70和P53蛋白的表达与甲状腺乳头状癌临床病理学特征的关系。结果:甲状腺乳头状癌组织中HSP7O和P53阳性表达率明显高于甲状腺良性病变组织及正常甲状腺组织(P<0.01)。HSP7O在甲状腺乳头状癌组织中的表达与是否有颈部淋巴结转移、浸润深度以及AJCC分期密切相关(P<0.01),而与年龄、性别、肿瘤的大小以及分化程度无关(P>0.05)。P53在PTC组织中的表达与组织分化程度、是否有淋巴结转移、浸润深度以及AJCC分期密切相关(P<0.01),而与年龄、性别、肿瘤的大小无关(P>0.05)。HSP70和P53蛋白在PTC组织中的表达呈正相关性(r=0.679,P<0.01)。结论:HSP70和p53蛋白在PTC中均呈高表达,并有协同作用,两者可作为预测PTC的生物学行为和预后的参考指标。     

假基因HMGA1L2在甲状腺肿瘤中的表达

应用RT-PCR技术检测假基因HMGA1L2在50例良、恶性甲状腺病变中HMGA1L2 mRNA的表达。结果显示HMGA1L2 mRNA在12例结节性甲状腺肿、9例甲状腺腺瘤和15例甲状腺乳头状癌中的阳性表达率均为100%, 而在14例甲状腺滤泡癌中的阳性率为35.7%, 与前3者差异有显著性。该研究首次报告了假基因HMGA1L2 mRNA在良、恶性甲状腺病变中的表达, 并且提示其在甲状腺滤泡癌与腺瘤的鉴别诊断中具有潜在的价值。     

Fibroblast Growth Factor Receptor-2 Expression in Thyroid Tumor Progression: Potential Diagnostic Application

Fibroblast growth factor receptor-2 (FGFR-2) plays an important role in tumorigenesis. In thyroid cancer it has been observed a FGFR-2 down-modulation, but the role of this receptor has not been yet clarified. Therefore, we decided to examine the expression of both FGFR-2 isoform, FGFR-2-IIIb and FGFR-2-IIIc, in different histological thyroid variants such as hyperplasia, follicular adenoma and papillary carcinoma. Immunohistochemistry and quantitative Real-Time PCR analyses were performed on samples of hyperplasia, follicular adenoma and papillary carcinoma, compared with normal thyroid tissue. Thyroid hyperplasia did not show statistically significant reduction in FGFR-2 protein and mRNA levels. Interestingly, in both follicular adenoma and papillary carcinoma samples we observed a strongly reduced expression of both FGFR-2 isoforms. We speculate that FGFR-2 down-modulation might be an early event in thyroid carcinogenesis. Furthermore, we suggest the potential use of FGFR-2 as an early marker for thyroid cancer diagnosis.     

不同性质甲状腺结节与微血管密度关系的研究

目的:探讨不同性质甲状腺结节与微血管密度关系,提高认识.方法:分别选取甲状腺乳头状癌、甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织,病理切片行常规HE染色及免疫组化SP染色.在高倍视野(×400)下选取5个血管着色密集区进行计数并取其平均数,MVD值=(n1 +n2+n3+n4+n5)/5.结果:(1)甲状腺乳头状癌、甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织平均MVD值分别为(65.54±19.21)个/HP、(54.54±11.76)个/HP、(47.85± 10.92)个/HP、(21.82±7.43)个/HP,甲状腺乳头状癌MVD值显著高于甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织(P＜0.05).甲状腺腺瘤、结节性甲状腺肿MVD值显著高于正常甲状腺组织(P＜0.05).(2)伴有淋巴结转移的甲状腺乳头状癌患者MVD值显著高于不伴有淋巴结转移者(P＜0.05);男性甲状腺乳头状癌患者MVD值显著高于女性患者(P＜0.05);＞40岁及≤40岁甲状腺乳头状癌患者MVD值间无统计学差异(P＞0.05).结论:甲状腺乳头状癌MVD值显著高于甲状腺腺瘤、结节性甲状腺肿及正常甲状腺组织,且伴有淋巴结转移的甲状腺乳头状癌患者MVD值显著高于不伴有淋巴结转移者.     

HSP70和P53蛋白在甲状腺乳头状癌中的表达及其与临床病理特征的关系

目的：探讨热休克蛋白70（HSP70）和P53蛋白在甲状腺乳头状癌组织中的表达及其与临床病理特征的关系。方法：应用免疫组织化学Envision法检测35例甲状腺乳头状癌组织、15例甲状腺良性病变组织及15例正常甲状腺组织中HSP70和P53蛋白的表达,分析HSP70和P53蛋白的表达与甲状腺乳头状癌临床病理学特征的关系。结果：甲状腺乳头状癌组织中HSP70和P53阳性表达率明显高于甲状腺良性病变组织及正常甲状腺组织（P〈0．01）。HSP70在甲状腺乳头状癌组织中的表达与是否有颈部淋巴结转移、浸润深度以及AJCC分期密切相关（P〈0．01）,而与年龄、性别、肿瘤的大小以及分化程度无关（P〉0．05）。P53在PTC组织中的表达与组织分化程度、是否有淋巴结转移、浸润深度以及AJCC分期密切相关（P〈0．01）,而与年龄、性别、肿瘤的大小无关（P〉0．05）。HSP70和P53蛋白在PTC组织中的表达呈正相关性（r=0．679,P〈0．01）。结论：HSP70和p53蛋白在PTC中均呈高表达,并有协同作用,两者可作为预测PTC的生物学行为和预后的参考指标：     

Expression and distribution of S-100, CD83 and apoptosis-related proteins (Fas, FasL and Bcl-2) in tissues of thyroid carcinoma

Previous studies have shown that dendritic cells (DCs) and apoptosis play a critical role in the pathogenesis of thyroid carcinoma (TC). This study was designed to investigate the expression and distribution of S-100 protein, CD83 and apoptosis-related proteins (Fas, FasL and Bcl-2) in the thyroid tissues of thyroid papillary carcinoma (TPC) and their role in TPC pathogenesis. Immunohistochemical staining techniques and other methods were used on pathological tissues of 30 patients with Thyroid papillary carcinoma (TPC) and 30 cases of thyroid follicular adenoma (TFA,as control) to detect the expression and distribution of S-100 protein, CD83, Fas, FasL and Bcl-2. A higher expression of S-100 protein in TPC (4.6+/-3.2%) vs.TFA (0.95+/-0.64%) (p<0.001) was observed as well as a higher expression of CD83 in the peri-cancerous tissues (PCT) (32.51+/-22.32) vs. TFA (5.19+/-8.08) (p<0.001), oppositely, CD83 was negative in the cancerous net.TPC showed greater increases in levels of Fas, FasL and Bcl-2 than did the TFA. Our findings suggest that impaired immune function, absence of CD83-positive mature and activated dendritic cells in cancer nodules may have a role in the pathogenesis of thyroid papillary carcinoma.The regulation of Fas, FasL and Bcl-2 in TPC may help them evade the immune system.     

Multiparameter analysis of AgNOR in thyroid lesions: comparison with PCNA expression

The aim of the study was to examine numerous features of argyrophilic proteins related to nucleolar organizer regions (AgNORs) in thyroid tumors, relate them to PCNA expression and evaluate which of these features might be useful in the diagnosis of thyroid lesions. Paraffin sections of 100 thyroid tumors were silver-stained and divided into 9 groups: nodular goiter (NG), simple adenoma (SA), microfollicular adenoma (MFA), follicular carcinoma (FC), follicular variant of papillary carcinoma (PC-F), classical variant of papillary carcinoma (PC-C), Hürthle cell adenoma (HA), Hürthle cell carcinoma (HC), and anaplastic carcinoma (AC). The slides were analyzed with the computerized system for image analysis. A weak correlation was found between PCNA expression and AgNOR size. AC differed significantly from all other examined groups in many features of AgNOR dots. Hürthle cell neoplasms were characterized by the presence of a usually single and relatively large dot. With respect to diagnosing follicular lesions, we found that the evaluation of the total area of dots in the nucleus seemed to be the most useful for discrimination: the assumption of 4.9 micro m2, as a cut-off value, allowed a correct classification of 77% of FC cases. Computer-aided morphometric analysis of AgNORs may be useful in the diagnostics of thyroid lesions.     

Intraoperative imprint cytology of the thyroid gland with computer-assisted morphometric analysis of cell clusters

Imprint preparations were used in addition to frozen sections in the intraoperative diagnosis of 37 cases of benign and malignant lesions of the thyroid gland, including adenomatous goiter, follicular adenoma, follicular carcinoma and papillary carcinoma. In the imprints, the cytologic features specific for carcinoma, as compared with benign lesions, were (1) the folding of the nuclear contour, (2) the increased density of the cytoplasmic matrix and (3) the frequent appearance of cell clusters of larger size. The size and frequency of cell clusters were morphometrically analyzed by a computer image analyzer. There was an increasing number of large clusters, plus the appearance of clusters of more than 300 micron in diameter, in both follicular and papillary carcinoma. In benign lesions, on the contrary, the majority of cells were isolated or in small clusters, the diameter of which never exceeded 300 micron in diameter. These results demonstrate that (1) the imprint cytology of the thyroid gland is useful in making a rapid intraoperative diagnosis and (2) the introduction of computer-assisted quantitative analysis is of practical value in the diagnosis of malignancy.     

Renal cell carcinoma metastatic to follicular adenoma of the thyroid gland. A case report

BACKGROUND: Renal cell carcinoma is an unpredictable tumor that can recur many years after the original diagnosis and metastasize to uncommon sites, including the thyroid gland. Differential diagnosis from primary thyroid tumor is often difficult both clinically and pathologically. We report a case of metastatic renal cell carcinoma in follicular adenoma of the thyroid gland. CASE: A 48-year-old woman presented with a 3-cm-diameter, palpable mass in the left lobe of the thyroid gland. The patient's history included removal of a left renal mass, which was conventional renal cell carcinoma. Fine needle aspiration cytology smears contained a few small clusters of polygonal cells with abundant, clear cytoplasm and irregular, hyperchromatic nuclei as well as bland-looking thyroid follicle cells and stromal cells. A papillary or follicular growth pattern was not detected. A cell block made from the aspirated sample was composed mainly of clear cells. By immunohistochemical stains, the clear cells were completely negative for TTF-1, thyroglobulin, calcitonin and inhibin while equivocally staining for cytokeratin, CD10 and galectin-3. The histologic diagnosis was renal cell carcinoma metastatic to follicular adenoma of the thyroid gland. CONCLUSION: Renal cell carcinoma metastatic to the thyroid may masquerade as a primary thyroid neoplasm. A history of prior nephrectomy, the presence of unremarkable thyroid follicle cells, the absence of a papillary or follicular growth pattern and immunohistochemical study can help differentiating metastatic renal cell carcinoma from a primary thyroid lesion with clear cell change.     

甲状腺肿瘤细胞核DNA含量测定对病理诊断的意义

应用真彩色医学图像分析技术, 对９０ 例甲状腺肿瘤（其中甲状腺腺瘤１０ 例, 不典型腺瘤１５ 例,乳头状腺癌２５ 例, 滤泡癌１５ 例, 髓样癌１５ 例, 未分化癌１０ 例） 细胞核ＤＮＡ含量进行了分析。结果显示,甲状腺腺瘤组与各型甲状腺癌比较均有显著性差异（Ｐ＜ ００１）,甲状腺腺瘤组同不典型腺瘤组比较无统计学意义（Ｐ＞ ００５）。甲状腺癌随组织分化程度的不同, ＤＮＡ 含量明显增加, 多为高倍异倍体细胞, ＤＮＡ直方图明显右移, 峰值主要位于≥５Ｃ处; 甲状腺腺瘤组ＤＮＡ含量较低, 多为低倍整倍体细胞, ＤＮＡ 直方图峰值位于２Ｃ－ ４Ｃ处; 不典型腺瘤组ＤＮＡ含量介于上述二者之间, ＤＮＡ 直方图逐渐右移。表明ＤＮＡ倍性程度与肿瘤的增殖程度呈正相关, 高倍异倍体细胞随肿瘤恶性程度的增高而增多。作者认为ＤＮＡ原位图像定量分析可为甲状腺肿瘤的诊断、分级及早期发现癌变趋势提供一个可靠的参考指标