Association Among Expression Of MMP-9 In Papillary Thyroid Carcinoma And Patterns Of Neck Lymph Node Metastasis

Objective:To study the correlation of expression in matrix metalloproteinase-9 (MMP-9) in papillary thyroid carcinoma(PTC) and the metastatic patterns of neck lymph nodes and to provide clinical guidance for reasonable application of function reserved neck dissection.Methods: Clinical records and pathological reports of 105 cases of papillary thyroid carcinoma from the frist affiliated hospital of Nanchang University (from 6,1995 -4, 2006) are reviewed. Specimens of 37 cases selected at random were investigated immunohistochemically and compared with samples of normal thyroid tissue taken from neighbouring regions of carcinoma by detecting the expression of MMP-9 respectively.Statistics analysis:SPSS13.0 system .Results:1,The positive expression rate of MMP-9 in PTC(37 cases)was 67.57% while 13.33% in the normal thyroid tissue (30 cases), which has statistic significant difference (P<0.05);2,In 37 cases of PTC, the positive expression rate of MMP-9 in male group was 60.00% and 70.37% in female group, which has no statistic significant difference(P>0.05);3,In 37 cases of PTC, the positive expression rate of MMP-9 in age≥45 years group was 77.78% and was 40.00% in age < 45 years group,which has statistic significant difference;was 85.71% in cases that tumor size >1cm and 43.75% in cases that tumor size≤1cm,which has statistic significant difference;52.63% in intact amicula cases and the figure was 83.33% in amicula destoried cases,which has statistic significant difference;90.00 % in positive proup of lymph node metastasis and was 41.18% in negative proup of lymph node metastasis ,which has statistic significant difference(P<0.05);4,In 37 cases of PTC, the positive expression of MMP-9 inⅠstage cases was 40.00% ,Ⅱstage was 66.67% and 91.67% inⅢstage , which has statistic significant difference(P<0.05);5,In 105 cases of PTC,the ratio of lymph node metastasis was 54.17% in male cases and 51.85% in females cases;which has no significant statistic difference(P>0.05);6,In 105 cases of PTC,the ratio of lymph node metastasis was 83.33% in age≥45 years cases and 31.75% in age<45 years cases, which has statistic significant difference;was 67.31% in tumor>1.0cm cases and 37.74% in tumor≤1.0cm cases,which has statistic significant difference;was 40.82% in intact amicula cases and 62.50% in destoried amicula cases,which has statistic significant difference (P<0.05);7,In cases of 105 PTC,the larger the tumor was ,the higher probability neck lymph node metastasis would be(r=0.794,P<0.01)。Conclusions:1,The expression of MMP-9 has no association with gender, but has correlation with age , tumor size, clinical stage and metastasis of lymph nodes.2,The expression of MMP-9 was closely correlative with lymph node metastasis. It may be clinically used as a predictive marker for the evaluation of lymph node metastasis in papillary thyroid carcinoma as functional neck dissection may be achoice.3,The most common cite of lymph node metastasis isⅥ,Ⅱ,Ⅲ,Ⅳdivision. Selective neck dissection includingⅥor evenⅡ-Ⅳdivisions are necessary in cases that thyroid amicula has been destroyed or extra-capsular invasion was found in operation.