TSLP和FOXP3在桥本氏甲状腺炎合并甲状腺乳头状癌中的表达及其临床意义

发布时间：2018-04-30 01:16

本文选题：胸腺基质淋巴细胞 + FOXP3　；参考：《扬州大学》2017年硕士论文

【摘要】：目的:随着肿瘤微环境和肿瘤的免疫调节的研究逐渐深入,调节性T细胞(regulatory T cell,Tregs)在肿瘤和自身免疫性疾病中的免疫机制成为研究热点。胸腺基质淋巴细胞(Thymic stromal lymphopoietin,TSLP)可以作用于树突状细胞促进Tregs细胞分化成熟。本研究将检测并分析在桥本氏甲状腺炎(Hashimoto's thyroiditis,HT)、甲状腺乳头状癌(papillary thyroid carcinoma,PTC)以及桥本氏甲状腺炎合并甲状腺乳头状癌中,Tregs细胞的上游细胞因子TSLP的表达和Tregs细胞浸润相关的FOXP3表达情况,以及在桥本氏甲状腺炎合并甲状腺乳头状癌中两者的相关性和临床病理意义。临床上桥本氏甲状腺炎合并甲状腺乳头状癌的发病率逐年增高,它们合并存在的发病机制尚未明确,有研究表明可能与自身免疫调节有一定关系,本研究通过探讨在桥本氏甲状腺炎合并甲状腺乳头状癌中,TSLP和FOXP3在免疫调节过程中所发挥的作用,为探索甲状腺中自身免疫性疾病合并恶性肿瘤的发病机制、临床诊断和治疗提供新的思路。方法:收集扬州大学附属苏北人民医院2012-2015年间在甲状腺乳腺外科接受手术治疗的部分甲状腺肿瘤患者189例,包括对照组结节性甲状腺肿25例、桥本氏甲状腺炎54例、甲状腺乳头状癌64例、合并桥本氏甲状腺炎的甲状腺乳头状癌46例。其中结节性甲状腺肿25例为阴性对照。患者术前均未接受甲状腺手术治疗、放射性碘治疗等。将收集的病人肿瘤组织标本按标准制作成石蜡切片,经HE染色和免疫组化SP法检测TSLP和FOXP3的表达情况。结果:1.TSLP在结节性甲状腺肿、单纯桥本氏甲状腺炎、单纯甲状腺乳头状癌、桥本氏甲状腺炎合并甲状腺乳头状癌组织中表达的阳性率分别是8%(2/25)、83.3%(45/54)、82.8%(53/64),95.6%(44/46);与结节性甲状腺组相比,单纯HT组、单纯PTC组和HT合并PTC组的TSLP 表达阳性率显著增高(χ2=40.243,p=0.000;χ2=4 χ620,p=0.000;χ2=54.549,p=0.000),差别具有统计学意义。桥本氏甲状腺炎合并甲状腺乳头状癌组的TSLP表达阳性率显著高于单纯HT组(χ2=3.850,p=0.049)和单纯PTC组(χ2=4.233,p=0.039),且差别具有统计学2.FOXP3在结节性甲状腺肿、单纯桥本氏甲状腺炎、单纯甲状腺乳头状癌、桥本氏甲状腺炎合并甲状腺乳头状癌组织中表达的阳性率分别是16%(4/25)、70.3%(38/54),60.9%(39/64),89.1%(41/46)。与结节性甲状腺肿相比,单纯桥本氏甲状腺炎组、单纯甲状腺乳头状癌组、桥本氏甲状腺炎合并甲状腺乳头状癌组的组织中FOXP3阳性表达率显著增高,且差别具有统计学意义(χ2=20.288,p=0.000;χ2=13.538,p=0.000;2=3.322,p=0.000)。HT合并PTC组的FOXP3的表达阳性率显著高于单纯HT组(χ2=5.269,p=0.022)和单纯PTC组(χ2=4.233,p=0.001),且差别具有统计学意义。3.临床资料分析示,桥本氏甲状腺炎合并甲状腺乳头状癌组中TSLP的表达阳性率与是否有淋巴结转移有关(χ2=3.920,p=0.048),且差别具有统计学意义,TSLP表达与性别、年龄、肿瘤大小以及 TNM 分期无关(χ2=1.012,p=0.314;χ22.971,p=0.085;χ2=0.915,p=0.339;χ2=6.509,p=0.011)。FOXP3的表达阳性率与是否有淋巴结转移(χ2=10.518,p=0.001)和临床TNM分期(χ2=1.012,p=0.314)相关,且差别具有统计学意义。FOXP3表达阳性率与性别、年龄、肿瘤大小无关(χ2=0.139,p=0.709;χ2=0.809,p=0.368;χ2=2.374,p=0.123)。4.在桥本氏甲状腺炎合并甲状腺乳头状癌中TSLP和FOXP3的阳性表达率呈正相关,且具有统计学意义(r=0.610,p=0.000)。结论:TSLP和调节性T细胞浸润相关的FOXP3在桥本氏甲状腺炎合并甲状腺乳头状癌中的表达与淋巴结转移相关,FOXP3的表达还与临床TNM分期相关,与年龄、性别、肿瘤大小无关。TSLP和FOXP3在桥本氏甲状腺炎合并甲状腺乳头状癌中的表达呈正相关,两者在这一疾病中发挥着协同作用,可能参与了桥本氏甲状腺炎合并甲状腺乳头状癌的免疫逃逸和免疫抑制过程,并可能对桥本氏甲状腺炎合并甲状腺乳头状癌的发生、发展和转移有一定影响。
[Abstract]:Objective: with the research of tumor microenvironment and tumor immunoregulation, the immunological mechanism of regulatory T cell (Tregs) in tumor and autoimmune disease has become a hot spot. Thymic matrix lymphocyte (Thymic stromal lymphopoietin, TSLP) can act on dendritic cells to promote the differentiation of Tregs cells. This study will detect and analyze the expression of TSLP in the upstream of the Tregs cell and the FOXP3 expression of the Tregs cell infiltration in the Hashimoto's thyroiditis (HT), papillary thyroid carcinoma (PTC), and Hashimoto's thyroiditis with papillary thyroid carcinoma. The correlation and clinicopathological significance of Hashimoto's thyroiditis with papillary thyroid carcinoma. The incidence of Hashimoto's thyroiditis with papillary thyroid carcinoma is increasing year by year. The pathogenesis of the combined thyroid carcinoma is not clear. To discuss the role of TSLP and FOXP3 in the immunoregulation of Hashimoto's thyroiditis with papillary thyroid carcinoma, and to provide new ideas for the exploration of the pathogenesis, clinical diagnosis and treatment of the autoimmune diseases in the thyroid gland and the clinical diagnosis and treatment of the thyroid gland. Methods: 2012-2015 years in the 2012-2015 years in the people's Hospital of Subei, affiliated to the people's Republic of China, were collected. 189 cases of thyroid tumor were treated by surgery, including 25 cases of nodular goiter in the control group, 54 cases of Hashimoto thyroiditis, 64 cases of thyroid papillary carcinoma and 46 cases of papillary thyroid carcinoma with Hashimoto's thyroiditis. 25 cases of nodular thyroiditis were negative control. The patients were not accepted before operation. Thyroid surgery, radioiodine treatment, etc.. The collected tumor tissue specimens were made into paraffin sections according to standard. The expression of TSLP and FOXP3 were detected by HE staining and immunohistochemical SP. Results: 1.TSLP was in nodular goiter, simple Hashimoto's thyroiditis, mono pure thyroid papillary carcinoma, and Hashimoto thyroiditis The positive rates of expression in thyroid papillary carcinoma were 8% (2/25), 83.3% (45/54), 82.8% (53/64), 95.6% (44/46). Compared with the nodular thyroid group, the positive rate of TSLP expression in the simple HT group, the pure PTC group and the HT combined PTC group was significantly higher (chi 2=40.243, p=0.000; chi square 620, chi square), the difference was statistically significant The positive rate of TSLP expression in Hashimoto's thyroiditis with papillary thyroid carcinoma was significantly higher than that of the simple HT group (x 2=3.850, p=0.049) and simple PTC group (x 2=4.233, p=0.039), and the difference has statistical 2.FOXP3 in nodular goiter, simple Hashimoto's thyroiditis, simple thyroid papillary carcinoma, Hashimoto's thyroiditis with thyroid The positive rates of expression in papillary carcinoma were 16% (4/25), 70.3% (38/54), 60.9% (39/64) and 89.1% (41/46). Compared with nodular goiter, simple Hashimoto's thyroiditis group, simple thyroid papillary carcinoma group, Hashimoto's thyroiditis with papillary carcinoma group had a significant increase in FOXP3 positive expression in the group of Hashimoto's thyroiditis and papillary thyroid carcinoma. The positive rate of FOXP3 (chi 2=20.288, p=0.000; X 2=13.538, p=0.000; 2=3.322, p=0.000).HT combined with PTC group was significantly higher than that of the simple HT group (x 2=5.269, p=0.022) and the simple group (chi square), and the difference was statistically significant. The positive rate of expression of TSLP was associated with lymph node metastasis (x 2=3.920, p=0.048), and the difference was statistically significant. The expression of TSLP was not related to sex, age, tumor size and TNM staging (x 2=1.012, p=0.314; Chi 22.971, p=0.085; Chi 2=0.915, p=0.339; Chi 2= 6.509, p=0.011). 10.518, p=0.001) and clinical TNM staging (x 2=1.012, p=0.314), and there was statistically significant difference in the positive rate of.FOXP3 expression with sex, age, and tumor size (x 2=0.139, p=0.709; Chi 2=0.809, p=0.368; Chi 2=2.374, p=0.123).4. in Hashimoto's thyroid papillary carcinoma and positive correlation of the thyroid papillary carcinoma R=0.610, p=0.000. Conclusion: the expression of FOXP3 associated with TSLP and regulatory T cell infiltration in Hashimoto's thyroiditis with papillary thyroid carcinoma is associated with lymph node metastasis. The expression of FOXP3 is associated with the clinical TNM staging. It is not related to age, sex, and tumor size of.TSLP and FOXP3 in Hashimoto thyroiditis. There is a positive correlation in the expression of thyroid papillary carcinoma, which plays a synergistic role in this disease. It may be involved in the immune escape and immunosuppression of Hashimoto's thyroiditis with papillary thyroid carcinoma, and may have a certain effect on the occurrence, development and metastasis of Hashimoto's thyroiditis with papillary thyroid carcinoma.

【学位授予单位】：扬州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.1;R581.4

【相似文献】