| Objective：By analyzing the expression of thyrotropin receptor in normal thyroidtissues and differentiated thyroid carcinoma tissues, to analyze the characteristics ofTSHR expression in DTC,and to explore the predictive value of TSHR in radioactiveiodine therapy of postoperation differentiated thyroid carcinoma.Methods: In the study49cases were retrospectively analyzed from january2010todecember2012. All the patients were pathologically diagnosd of differentiated thyroidcarcinoma postoperative of subtotal thyroidectomy or near total resection in the firstAffiliated Hospital of Dalian Medical University. All the patients were given radioactiveiodine therapy after operation,and all patients were followed for more than1year. Therewere38famale patient and11male patients enrolled,and their age ranged from24to78years old.All the cases were TNM staged from T1N1M0-T4N1M0.A therapeutic doseof5.55GBq was given in131I thrapy in three monthes after surgery because ofpathologically diagnosed lymph node metastasis and ultrasound diagnosed abnormallymphadenopathy. One week later the WBS was given for DTC re-staging in order toguide subsequent treatment and the effect was assessed four monthes later after131Ithrapy. A successful thyroid clear was considered if the WBS displayed no abnormalsystemic radionuclide uptake and the serum globulin continuing less than1ng/ml,otherwise the second131I treatment would be given. According to the treatment of theradioactive iodine therapy all the patients were divided into two groups: A group were enrolled in30cases that who were give only once thrapy when successful thyroid clear,and Group B totally19cases were the patients undergoing twice or more thrapies whensuccessful thyroid clear.The method of immunohistochemical avidin-biotin-peroxidasecomplexes (ABC) were used to detect the location and intensity of TSHR expression inthe tissue of thyroid cancer and normal thyroid nearby. The TSHR expression wereshowed by yellow to brown coloration in the basement membrane and cytoplasm of thecells.The expression were judged basing on the sum score of the percentage of po.sitivecells ratio and the staining intensity.The effects of the radioactive iodine therapypostoperation and the relationship between TSHR and the treament were evaluatedcombining to clinical data including age,sex,nodule diameter and whether the aroundviolations or not. The SPSS17.0statistical software was application for statisticalanalysis according to α=0.05significance level.Results:1、The two groups of patients with the basis of the date of and were notstatistically different (P＞0.05).There were no statistical difference between two groupsabout the sex ratio,age,diameter of thyroid nodules and the existence or not of invasionaround the tumor（P＞0.05）.2、The positive rate of cell basement membrane TSHR expression was100%in thenormal thyroid tissues in the pathological section and57.14%in the differentiatedthyroid carcinoma tissues. The difference was statistically significant(P＜0.05）.Thepositive rate of cytoplasm TSHR expression was87.76%in the tumor tissues and it wassignificantly higher than the rate of32.65%in the normal thyroid tissues(P＜0.05）.3、In the49tumor pathological sections,the TSHR positive expression rate in cellbasement membrane (positive rate70.00%and strong positive rate46.67%)was higherin group A than group B(positive rate36.84%and strong positive rate15.79%),and thedifference was statistically significant(P＜0.05).There was no statistical differencebetween two group in the cytoplasm TSHR expression level(group A positive rate86.67%and strong positive rate40.00%,group B positive rate89.47%and strongpositive rate47.37%)（P＞0.05）. Conclusion:1、The feature including the patient’s age, sex, size of lesions and the existence ornot of invasion around the tumor will not influence the treatment of radioactive iodinetherapy.2、 Expression of TSHR in the cell basement membrane is lower in thedifferentiated thyroid carcinoma than in the normal thyroid tissue.There is highercytoplasm TSHR positive expression in the differentiated thyroid carcinoma than in thenormal thyroid tissue.3、High positive expression of TSHR in the basement membrane of thyroidfollicular cells may indicate good effect of the radioactive iodine therapy,and it can beused as predictive indicator of the treatment. |
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