The Research On The Expressions Of ER、PR And The Effect Of¹³¹I Therapy In Postoperative Patients With PTC

Objective To investigate the correlation between the expressions of estrogen receptors(ER), progesterone receptors (PR) and the patterns of cervical lymph node metastasis and the effect of131I therapy in postoperative patients with Papillary Thyroid Carcinoma (PTC).Methods The immunohistochemical technique was used to test the expression of ER and PR in tissues of67postoperative patients with PTC. According to pathological results recorded cervical lymph node metastasis and serum Tg and131I whole body imaging, the relationship of ER and PR expression between neck lymph node metastasis and therapeutic effect were studied.The patients who131I Whole Body Imaging (131I-WBI) was negative or the swollen lymph nodes were found in cervical ultrasound test and131I treatment results were poor were examined with18F-FDG PET/CT fusion imaging. Univariate analysis with the chi-square test was used to analyze the correlation between lymph node metastasis and the other clinical factors. Multiple logistic regression analysis was used identify the multivariate correlates of lymph node metastasis. Serum thyroglobulin (Tg) was normal or significantly reduced,131I Whole Body Imaging (131I-WBI) was negative or the number of them decreased and new metastases was not found in cervical ultrasound test.Results The positive rates of ER and PR in67PTC patients were10.4%(7/67) and41.8%(28/67).7cases with ER positive had5cases with lymph node metastasis.Metastatic rate was71.42%;60cases with ER negative had41with lymph node metastasis. Metastatic rate was68.33%. PR positive of28cases had19cases with lymph node metastasis. Metastatic rate of67.86%; PR negative of39cases had27cases with lymph node metastasis. Metastatic rate was69.23%.Of positive ER and PR in5 cases,4cases were with lymph node metastasis and the metastasis rate was80%; Of negative ER and PR37cases,26cases were with lymph node metastasis. Metastasis rate was70.27%. ER and PR positive expression compared with cervical lymph node metastasis rate, there was no statistically significant difference (p>0.05). Of67patients, ER was positive in7cases and the effective rate of131I therapy was100%(7/7); ER was negative in60cases and the efficiency88.33%(53/60). PR was positive in28cases and the efficiency was82.14%(23/28); PR was negative in39cases and the efficiency94.74%(36/39). The corresponding effective rate of131I therapy was no-significant by X2test(X2=1.060,1.602; p=0.303,0.206).8patients who were negative in131I-whole body imaging underwent18F-FDG PET/CT fusion imaging.4cases were diagnosed as cervical lymph node reactive hyperplasia and2cases were lymph node metastasis in6female patients.2cases of male were lymph node metastasises. The lymph node metastasises were confirmed by operation and pathology.Conclusion The ER, PR positive expression rate in patients with PTC was not related to lymph node metastasis and local invasion. The ER, PR positive expression was not related to the effect of131I therapy in postoperative patients with PTC. Sex, tumor size and number, lymph node metastasis can impact the therapeutic effect of131I.18F-FDG PET/CT fusion imaging high metabolism can prompt PTC postoperative metastasis and tumor differentiation, is an important basis for diagnosis of the clinical treatment of PTC patients.