Analysis Of Clinical Features And The Expression And Significance Of E-cadherin And Vimentin In27Poorly Differentiated Thyroid Carcinomas

Objective:To investigate the diagnostic methods in poorly differentiated thyroid carcinoma and contrastive analysis the difference between poorly differentiated thyroid carcinoma and well differentiated thyroid carcinoma on pathological features.To discuss the expression and significance of E-cadherin and Vimentin in poorly differentiated thyroid carcinoma.Methods:1584cases patients who accepted thyroid cancer surgery were collected from May2003to May2013, Xiangya Hospital,which included1451definitely diagnosed differentiated thyroid cancer cases.While the other cases impossible to be grouped will be sliced and read the piece again,and then we screened out27poorly differentiated thyroid carcinoma cases.In the end we investigated the clinical feature differences through comparing27poorly differentiated thyroid carcinoma cases with1451differentiated thyroid carcinoma cases.The expression information of E-cadherin and Vimentin in27poorly differentiated thyroid carcinoma cases,35well differentiated thyroid carcinoma cases,6anaplastic thyroid carcinoma cases,10benign thyroid tumor cases were detected and analysed with immunohistochemical methods.Results:27poorly differentiated thyroid carcinoma cases were diagnosed after operation,and there were26cases (96.30%)growed in line with the insular pattern and20cases(74.07%) growed with trabecular/solid pattern.While19cases(70.37%) growed with both of former pattern and only one case (3.70%) growed with three patterns together. All of the cases lacked the typical nuclear feature of papillary carcinoma,among which16cases (59.26%) were in mitotic≥3X10HPF(per10high-power microscope),and15cases were accompanied with necrosis(55.56%).The result of immunohistochemical staining displayed that the positive rate of thyroglobulin(TG)was100%(20/20),TTF-1was76.92%(10/13), CK was71.43%(10/14), syn positive rate of9cases was11.11%(1/9); the coefficient values of5cases Ki67detection were all less than30%;the detection results of1case for P53,1case for Bcl-1, and15cases for Calcitonin were all negative.The clinical pathological features of poorly differentiated thyroid carcinoma (tumor size,thyroid extracapsular invasion,distant metastasis,tumor vascular invasion,lymph node metastasis,and tumor staging)were obviously different from well differentiated thyroid carcinoma (P<0.05), while the difference on sex and age composition was not that significant (P>0.05).It was confirmed with immunohistochemistry method that E-cadherin-/Vimentin+positive rate of poorly differentiated thyroid carcinoma ranged from differentiated thyroid carcinoma to anaplastic thyroid cancer,and E-cadherin-/Vimentin+positive rate of poorly differentiated thyroid carcinoma was obviously higher than that of differentiated thyroid carcinoma and benign thyroid tumors(P<0.05), while no significant difference from anaplastic thyroid carcinoma (P>0.05).Conclusions:1.The diagnosis of poorly differentiated thyroid carcinoma was mainly depended on its morphological features of tissue and cell, while the positive expression of TG, TTF-1, CK and negative expression of syn, calcitonin were aided to the diagnosis.2.There were the apparent feature of invasion and metastasis when poorly differentiated thyroid carcinoma compared with well differentiated thyroid carcinoma.3.Down-regulation of E-cadherin and upregulation of Vimentin existed in poorly differentiated thyroid carcinoma and E-cadherin-/Vimentin+positive rate was significantly higher than that of differentiated thyroid carcinoma and benign thyroid tumors (P<0.05),while no significant difference from anaplastic thyroid carcinoma(P>0.05).A11these may prompt that poorly differentiated thyroid carcinoma was more invasive than well differentiated thyroid carcinoma in growth pattern.