LMTK3在甲状腺乳头状癌中的表达及临床意义

发布时间：2018-03-30 04:39

本文选题：甲状腺乳头状癌　切入点：LMTK3　出处：《遵义医学院》2017年硕士论文

【摘要】：目的:检测狐猴酪氨酸激酶-3(Lemur tyrosine kinase-3,LMTK3)在甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)患者血清及组织中的表达,分析其与患者临床病理参数之间的关系,并探讨其临床意义。方法:1.LMTK3在甲状腺乳头状癌患者血清中的表达及意义收集手术切除后病理确诊的31例PTC患者血清、24例甲状腺良性病变(Thyroid benign lesion,TBL)患者血清以及32例健康自愿者(Health volunteer,HV)血清。通过酶联免疫吸附测定法(Enzyme-linked immunosorbent assay,ELISA)检测患者血清中LMTK3表达情况。同时,追踪患者住院期间的血清甲状腺球蛋白(Thyroglobulin,Tg)检测值,初步探讨LMTK3与Tg在血清学鉴别诊断PTC的潜在临床价值。2.LMTK3在甲状腺乳头状癌患者组织中的表达及意义收集手术切除后病理确诊的10例PTC配对冰冻组织及10例TBL冰冻组织、106例甲状腺乳头状癌及22例TBL石蜡包被组织。通过q RT-PCR及Western blot分别检测冰冻组织中LMTK3 m RNA和蛋白中的表达情况。免疫组化检测石蜡包被组织中LMTK3以及ERα蛋白表达情况,分析二者相关性,并探讨其临床意义。结果:1.LMTK3蛋白在PTC组血清中的平均表达含量(1.51±1.22)ng/ml明显高于TBL组(0.66±0.87)ng/ml和HV对照组(0.65±0.91)ng/ml,具有统计学意义(P0.05)。应用受试者工作特征曲线(ROC)比较血清LMTK3在PTC实验组与对照组1(TBL组)以及对照组2(TBL和HV对照组)之间的诊断价值,二者的曲线下面积分别是0.720(P=0.006)和0.709(P=0.001)。同时追踪患者住院期间检测的血清Tg值,PTC组及TBL组血清Tg的平均含量分别是(44.11±106.3)ng/ml和(117.9±121.1)ng/ml,均高于正常值。进一步比较血清LMTK3与Tg在PTC组与TBL组的特异性、敏感性等指标,结果提示血清LMTK3在鉴别PTC的价值可能会优于血清Tg。2.LMTK3蛋白在PTC癌组织中的表达明显明显高于PTC癌旁组织(P0.001)和TBL组织(P0.001)。LMTK3在组织中的表达情况与患者临床分期显著相关(P=0.01),而与患者的性别、年龄、肿瘤大小、淋巴结转移以及远处转移无明显相关性(P0.05)。3.雌激素受体α(Estrogen receptorα,ERα)蛋白在PTC癌组织中的表达明显高于PTC癌旁组织(P0.001)和TBL组织(P0.001)。ERα在组织中的表达情况与患者原发肿瘤大小呈正相关(P=0.017),而与患者性别、年龄、淋巴结转移、远处转移以及临床分期无明显相关性(P0.05)。4.LMTK3蛋白在PTC癌组织中的敏感性及特异性均高于ERα蛋白,且二者在甲状腺病变组织中表达含量之间的相关系数r为0.292,具有统计学意义(P0.001)。结论:1.LMTK3在甲状腺乳头状癌患者血清中表达明显高于甲状腺良性病变患者及健康自愿者,且其特异性、敏感性等优于血清Tg;2.LMTK3甲状腺乳头状癌患者组织中表达显著上调,其表达与患者临床分期呈正相关,提示LMTK3作为致癌因子可能参与甲状腺乳头状癌的发生、发展过程;3.LMTK3与ERα在组织层面表达呈正相关,推测在甲状腺乳头状癌中LMTK3与ERα之间可能也存在一定的调控关系。
[Abstract]:Objective: to detect the expression of Lemur tyrosine kinase-3 (LMTK3) in serum and tissues of papillary thyroid carcinoma of thyroid (Papillary thyroid carcinoma-PTC3) patients, and to analyze the relationship between the expression of Lemur tyrosine kinase-3 and the clinicopathological parameters of patients with papillary thyroid carcinoma of thyroid. Methods 1. Expression and significance of LMTK3 in serum of patients with papillary thyroid carcinoma. The expression of LMTK3 in serum of healthy volunteers was detected by Enzyme-linked immunosorbent Assay Assa (ELISAs). At the same time, the expression of LMTK3 in the serum of healthy volunteers was determined by enzyme-linked immunosorbent assay (Elisa). The serum Thyroglobulinine (TG) levels were measured during hospitalization. Preliminary study on the expression and significance of LMTK3 and TG in the differential diagnosis of PTC by serology. 2. Expression and significance of LMTK3 in thyroid papillary carcinoma; 10 cases of PTC paired frozen tissue and 10 cases of TBL frozen tissue confirmed pathologically after resection. The expression of LMTK3 m RNA and protein in frozen tissue was detected by Q RT-PCR and Western blot. The expression of LMTK3 and ER 伪 protein in paraffin tissue was detected by immunohistochemistry. Analysis of the correlation between the two, Results 1.The average expression of LMTK3 protein in serum of PTC group was significantly higher than that of TBL group (0.66 卤0.87)ng/ml) and HV control group (0.65 卤0.91ng / ml). The diagnostic value of 2(TBL and HV between the two groups (1(TBL group and control group) and the control group (2(TBL and HV control group) were analyzed. The areas under the curve were 0.720 卤0.709 and 0.709 respectively. The mean levels of TG in serum of PTC group and TBL group were 44.11 卤106.3)ng/ml and 117.9 卤121.1 ng / ml, respectively, which were higher than the normal value. Further comparison was made between serum TG and serum TG in PTC group. Specific to TBL group, Sensitivity and other indicators, The results suggest that the value of serum LMTK3 in differentiating PTC may be better than the expression of serum Tg.2.LMTK3 protein in PTC cancer tissues, which is significantly higher than that in PTC adjacent tissues (P0.001) and TBL tissues (P0.001P0.001. LMTK3 expression is significantly correlated with the clinical stage of the patients. P, P, 0. 01, while with the patient's gender, Age, tumor size, There was no significant correlation between lymph node metastasis and distant metastasis. The expression of estrogen receptor 伪 Estrogen receptor 伪 ER 伪) in PTC was significantly higher than that in PTC adjacent tissues (P0.001) and TBL tissues. The expression of ER 伪 in tissues was significantly higher than that in patients with primary tumor size. There was a positive correlation between P0. 017 and the sex of the patient. Age, lymph node metastasis, distant metastasis and clinical stage were not significantly correlated with the sensitivity and specificity of LMTK3 protein in PTC carcinomas, and the sensitivity and specificity of LMTK3 protein were higher than that of ER 伪 protein. The correlation coefficient between the two expression levels in thyroid lesions was 0.292, which was statistically significant (P 0.001). Conclusion the expression of LMTK3 in serum of patients with thyroid papillary carcinoma is significantly higher than that of patients with thyroid benign lesions and healthy volunteers, and the expression of LMTK3 in serum of patients with thyroid papillary carcinoma is significantly higher than that of patients with thyroid benign lesions and healthy volunteers. Moreover, the specificity and sensitivity of LMTK3 were higher than that of serum Tg2. 2. The expression of LMTK3 was significantly up-regulated in patients with papillary thyroid carcinoma, and the expression was positively correlated with the clinical stage. It suggested that LMTK3 as a carcinogen might be involved in the development of papillary thyroid carcinoma. 3. The expression of LMTK3 and ER 伪 was positively correlated with the expression of ER 伪 in thyroid papillary carcinoma, which suggested that there might also be a regulatory relationship between LMTK3 and ER 伪 in papillary thyroid carcinoma.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R736.1

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