Expression And Significance Of ER, PR, PCNA In Differentiated Thyroid Cancer

Objective: Since the mid-1980s, the former Soviet Chernobyl nuclearpower plant leak, thyroid cancer is the fastest growing entity of the past20years the incidence of malignant tumors, the average annual growth of6.2%.Currently, the incidence has accounted for five of the female malignancy. Theincidence of thyroid cancer rises with increasing age, the highest incidence ofthe age of30-60years old. Differentiated thyroid cancer overall10-yearsurvival rate of85%; medullary thyroid cancer,10-year survival rate was75%;anaplastic thyroid cancer mortality rate of about50%, and general survivaltime from diagnosis to death is only4-8months[1-3]. The incidence of thyroidcancer for women men3-5times, especially the women of child-bearingperiod is particularly evident[4]years old before the incidence of thyroidcancer with no significant relationship between gender, since then theincidence of thyroid cancer, women significantly increased[5]. Endogenousestrogen secretion around the age of ten women have begun to increase, theincrease in estrogen secretion and young people, especially young women,thyroid cancer occurred. Thyroid cancer is estrogen dependent tumors isinconclusive[6]. Estrogen and progesterone on the role of thyroid tissue mainlythrough its receptor, estrogen and progesterone receptor (ER, PR) relationshipwith thyroid cancer, are increasingly valued by scholars.Identification of malignant and benign thyroid nodule, regardless ofimaging, fine needle aspiration cytology or frozen section examination thereare defects and errors will inevitably cause some false-negative results, so weneed to find a specific, high sensitivity of thyroid cancer molecular markers tofacilitate early diagnosis, make a reasonable treatment options and prognosis.Proliferating cell nuclear antigen (PCNA) is a regulation of DNA synthesisand cell proliferation caused by cyclin expression can effectively evaluate cell proliferation status, and the basic characteristics of the tumor cell cycleregulation disorders lead to uncontrolled cell proliferation, cell proliferationactivity to reflect the tendency of malignant tumors. PCNA is receiving moreattention a cell proliferation associated nuclear antigen as cell proliferationactivity of specific markers.Estrogen receptor, progesterone receptor and PCNA expression in thyroidcancer, how, and thyroid cancer biometrics, such as patients’ gender, age,lymph node metastasis of how there is no clear conclusion, this study aims toexplore ER, PR, and PCNA expression in differentiated thyroid carcinomaand its significance.Methods: Select the Third Hospital of Hebei Medical Pathology archived2003-2012clinical and pathological data complete surgical resection of thethyroid tissue, all specimens were further review after senior pathologist. Allcases are starting, did not receive preoperative radiotherapy and chemotherapy.Random sample29cases of papillary thyroid carcinoma,20cases in thyroidfollicular carcinoma,20cases of thyroid adenoma,20cases of nodular goiter;using immunohistochemical SP method to detect all specimens, Research ER,PR, PCNA and differentiated thyroid cancer the relationship and its correlation.Immunohistochemical results criteria: First, the percentage of positive cellsscore: the number of positive cells <10%0points,10%-25%for1points, and26%-50%for2points,51%-75%3points,>75%4points; followed by thedegree of staining score: light yellow scored1point,2points brownish yellow,tan three points, and then calculate the product. Product <3of the specimen isnegative, the product is≥3specimens as positive. Statistical analysis using theSPSS13.0processing data using χ~2test, fishers testing the Krukal-WallisHRank and inspection, Nemeny method rank sum test, and Spearman rankcorrelation analysis, there are significant differences (P <0.05).Results:1The expression of ER in thyroid different histological types: ERpositive rate were55.17%in thyroid papillary carcinoma, in follicularcarcinoma, the positive rate was60.0%, positive rate was20.0%in adenomas, Positive rate was15.0%in nodular goiter, positive expression of ER papillarythyroid cancer rate is higher than the rate of expression in thyroid adenomaand nodular goiter, there are significant differences in the statistical analysis(P <0.05). ER expression with age was negatively correlated: at <40years ofage, ER positive rate in papillary thyroid carcinoma was significantly higherthan papillary carcinoma of≥40years of age, there is a significant difference(P <0.05).ER positive rate in thyroid follicular carcinoma patients age,regardless of gender (P>0.05).2PR expression in thyroid different histological types: PR positive rate inpapillary thyroid carcinoma were51.72%, the positive rate was50.0%infollicular carcinoma,35.0%positive rate of adenomas, the positive rate was20.0%in nodular goiter, the positive expression rate of PR in papillary thyroidcarcinoma was higher than in nodular goiter, a significant difference (P <0.05);the expression of PR in between papillary thyroid carcinoma and follicularcarcinoma was no significant difference (P>0.05). PR and lymph nodemetastasis were negatively correlated: PR positive rate was significantlyhigher than that in papillary thyroid cancer without lymph node metastasis,lymph node metastasis of papillary carcinoma (P<0.05). The abnormalexpression of PR in papillary thyroid cancer, regardless of patient gender andage (P>0.05). PR expression in thyroid follicular carcinoma unrelated withthe patient’s gender, age, lymph node metastasis (P>0.05).3The expression of PCNA in the thyroid of different histological types:PCNA-positive rate were58.62%in thyroid papillary carcinoma, the positiverate was80.0%in follicular carcinoma, positive rate was30.0%in adenoma,The positive rate of20.0%in nodular goiter, the expression of PCNA inthyroid papillary carcinoma and follicular carcinoma between no significantdifference; expression of PCNA protein in papillary carcinoma higher thyroidadenoma and nodular thyroid swollen tissue, significant differences (P <0.05),the expression of PCNA in thyroid papillary carcinoma with lymph nodemetastasis higher than those without lymph node metastasis papillarycarcinoma, the difference was significant (P <0.05), the positive rate of PCNA in differentiated thyroid cancer and the patient’s gender, age, unrelated (P>0.05).4The correlation of ER, PR, and PCNAER and PR was positively correlated in papillary thyroid cancer(correlation coefficient: r=0.447, P=0.015)(P<0.05). PCNA with ER, PRwas negatively correlated in papillary thyroid carcinoma (correlationcoefficients were:(1) r=-0.455, P=0.013;(2) r=-0.441, P=0.017)(P <0.05).ER and PR were positively correlated in thyroid follicular carcinoma(correlation coefficient: r=0.526, P=0.017)(P <0.05). ER and PCNA wasnegative correlation in thyroid follicular carcinoma (correlation coefficient: r=-0.634, P=0.003)(P <0.05), PCNA and PR is no significant correlation (r=-0.388, P=0.091, P>0.05)..Conclusions:1Thyroid benign and malignant lesions can be detected ER and PRexpression in differentiated thyroid cancer rate was higher than benignthyroid tumor tissues. ER with age was negatively correlated the in papillarythyroid carcinoma. Estrogen is likely to be an important factor to inducedifferentiated thyroid cancer.2PCNA expression in differentiated thyroid cancer rate was significantlyhigher than benign thyroid tissue; PCNA expression in lymph node metastasesof differentiated thyroid cancer is higher than without lymph node metastasis,PCNA can be used as the evaluation of the degree of malignancy of thyroidcancer, and can reflect prognosis.3ER, PR, PCNA higher positive expression in differentiated thyroidcarcinoma and correlation, three in the incidence of thyroid cancerdevelopment, invasion and metastasis are playing an important role, the threejoint detection for thyroid cancer diagnosis, treatment and prognosissignificance.