甲状腺乳头状癌中MMP2、COX-2、VEGF和MVD的表达及临床意义
Expressions of MMP2, COX-2, VEGF and MVD in papillary thyroid carcinoma and their clinical significance

摘要：目的 研究甲状腺乳头状癌(PTC)中环氧合酶-2(COX-2)、血管内皮生长因子(VEGF)、基质金属蛋白酶(MMPs)表达和微血管密度(MVD)计数与PTC的临床病理特征之间的关系，并用以评估恶性程度、预后。方法 运用免疫组化染色方法，检测32例PTC和18例正常甲状腺组织中的COX-2、VEGF、MMP2表达和MVD计数，并分析其与临床病理特征的关系。结果 COX-2、VEGF、MMP2和MVD在PTC中的表达分别为(中位数和四分位距表示)：M(Q3-Q1)=5(1)，M(Q3-Q1)=5.5(2)，M(Q3-Q1)=5.5(1)和M(Q3-Q1)=28(5.75)，与对照组相比差异均有统计学意义(P<0.05)。 COX-2、VEGF、MMP2、MVD的计数表达与患者的年龄、临床分期、淋巴结转移有关(P<0.05)；COX-2与VEGF还与性别有关(P<0.05)；VEGF、MMP2的表达及MVD的计数还与患者肿瘤大小有关(P<0.05)。COX-2、VEGF、MMP2和MVD在被膜浸润组中的表达分别为：M(Q3-Q1)=6(2)，M(Q3-Q1)=6.5(2)，M(Q3-Q1)=6(1.75)和M(Q3-Q1)=30(7.75)，被膜未浸润组中的表达为：M(Q3-Q1)=5(1.75)，M(Q3-Q1)=5(1.75)，M(Q3-Q1)=5(1.75)和M(Q3-Q1)=26.5(4)；COX-2、VEGF、MMP2和MVD在被膜浸润组与未浸润组之间的表达差异具有统计学意义(P<0.05)。PTC中COX-2、MMP2、VEGF和MVD的表达相互之间具有显著的正相关性(r>0.5)。结论 甲状腺组织中MMP2、COX-2、VEGF的高表达可能促进了PTC的发生和肿瘤淋巴结转移；这与调控肿瘤新生血管有关。检测其表达对评估PTC的恶性程度及预后有一定意义。
ABSTRACT: Objective To investigate the expressions of cycloxygenase-2 (COX-2), vascular endothelial growth factor (VEGF), matrix metalloproteinase (MMP2) and micro-vessel density (MVD) in papillary thyroid carcinoma (PTC) and the relationship between their expressions and clinicopathological features, so as to evaluate the malignancy and prognosis of PTC. Methods The expressions of COX-2, MMP2 and VEGF and MVD count in 32 cases of PTC and 18 cases of normal thyroid tissues were detected by immunohistochemical staining. Their relationship with clinicopathological characteristics was analyzed. Results ① The expression of COX-2, MMP2, VEGF and MVD in PTC was as follows: M(Q3-Q1)=5(1), M(Q3-Q1)=5.5(2), M(Q3-Q1)=5.5(1) and M(Q3-Q1)=28(5.75), respectively. It differed significantly from that in control group (P<0.05). ② The expression of COX-2 in PTC was related to the sex and age of patients, clinical stage and lymph node metastasis (P<0.05). The expression of VEGF in PTC was related to the sex and age of patients, tumor size, clinical stage and lymph node metastasis (P<0.05). The expression of MMP2 and MVD count in PTC were related to the age of patients, tumor size, clinical stage and lymph node metastasis (P<0.05). ③ The expression of COX-2, MMP2, VEGF and MVD in PTC with invasion of thyroid capsules was as follows: M(Q3-Q1=6(2), M(Q3-Q1)=6.5(2), M(Q3-Q1)=6(1.75) and M(Q3-Q1=30(7.75). The expression of these indexes in negative group was: M(Q3-Q1)=5(1.75), M(Q3-Q1)=5(1.75), M(Q3-Q1)=5(1.75) and M(Q3-Q1)=26.5(4). There was a significant difference between the two groups (P<0.05). ④ There was a close positive correlation between the expressions of VEGF, COX-2, MMP2 and MVD in PTC (r>0.5). Conclusion The high expressions of COX-2,