| Objective:1.To explore the expression of FOXO1 and S1P1 in the thymoma with myasthenia gravis,the simple thymoma,thymus hyperplasia,and normal thymus tissue,to further understand correlation with clinical significance.2.To text the expression levels of FOXO1 and S1P1 in thymoma tissues with myasthenia gravis,and to further analyze the relationship beween gender, age, type of organization, Masaoka stage, Osserman classification and Ab– Ach R.3. To analyze correlation of FOXO1 and S1P1 to the peripheral blood T cells in the thymoma with myasthenia gravis.4. To explore the correlation and significance between the expression of FOXO1 and S1P1 in the thymoma with myasthenia gravis.Methods:1. Using SP immunohistochemical method to test the expression of FOXO1 and S1P1 in the 18 cases of thymoma with myasthenia gravis, 5 cases of simple thymoma,2cases of thymus hyperplasia,and 4 cases of normal thymus.2.With the application of real-time fluorescent quantitative PCR SYBR Green fluorescent method,we detect the m RNA expression of FOXO1 in the thymoma with myasthenia gravis,the simple thymoma,thymus hyperplasia,and normal thymus tissue.3.Using direct immunofluorescence staining and flow cytometry instrument.we detect the percentage of T lymphocyte subsets CD4 ~+, CD8 ~+ and CD4 ~+ / CD8 ~+ in peripheral blood.4.Using SPSS11.5 statistical software,we analysis relevant levels between the expression of FOXO1 and S1P1 and the related factors.Results:1. The positive expression rate of FOXO1 in thymoma with myasthenia gravis is88.9%(16/18), and strong positive expression is 66.7%(12/18); the positive expression rate in patients with simple thymoma is 40%(2/5), and strong positive expression is 20%(1/5); the positive expression rate in patients with thymus hyperplasia is 100%(2/2); the positive expression rate in patients with normal thymus is 25%(1/4). FOXO1 expressed in thymoma with myasthenia gravis group issignificantly higher than simple thymoma group(P < 0.05) and normal thymus group(P < 0.05); but FOXO1 expression rate of thymus hyperplasia with myasthenia gravis group has no obvious difference with thymoma with myasthenia gravis group(P >0.05). In thymus hyperplasia tissues,FOXO1 is mainly expressed in the thymus cortex and medulla of the nucleus and cytoplasm, the cell nucleus express more;In thymoma with myasthenia gravis, FOXO1 is mainly expressed in the medulla island and the surrounding, cell cytoplasm express more; normal thymus and simple thymoma express patches.2. The S1P1 positive expression is 83.3%(15/18) in thymoma with myasthenia gravis positive, and strong positive expression rate is 72.2%(13/18);In the simple thymoma,expression rate is 40.0%(2/5), strong positive expression rate 40%(2/5);In thymus hyperplasia,expression rate is 100%(2/2), strong positive expression rate 50%(1/2);In normal thymus,the positive expression rate is low.S1P1 is expressed differently in the four groups of tissue samples(P < 0.05); The positive expression has no obvious difference between the thymoma with myasthenia gravis patients and thymic hyperplasia(P > 0.05), but It has more significant difference than the simple thymoma and normal thymus tissue expression(P < 0.05).S1P1 is mainly expressed in the cytoplasm and cell membrane.S1P1 in thymus hyperplasia tissue is mainly distributed in the medulla of thymus and is mainly distributed in medulla island and surrounding blood vessels in thymoma; normal thymus express patches.3. The test results of FOXO1 m RNA are 4.32±0.86,5.99±1.50,4.38±0.25,6.69±0.03 in thymoma with myasthenia gravis, simple thymoma, thymus hyperplasia, and normal thymus tissue in sequence.In four groups there was significant difference(P = 0.001).The FOXO1 m RNA of thymoma with myasthenia gravis is obviously higher than that of simple thymoma(P < 0.05).4. FOXO1 and S1P1 are expressed parallelly in thymoma with myasthenia gravis,and the correlation analysis shows that there is relationship(γ= 0.481, P = 0.481 <0.05).There is highly positive correlation between FOXO1(or S1P1) expression and CD4~+(or CD4~+ / CD8~+)T lymphocytes(P < 0.01), it has no obvious relation with CD8(P > 0.05). There are no obvious correlations between FOXO1(or S1P1)expression and gender, age, Masaoka staging, Osserman classification, tissue types,Ab –Ach R.Conclusion:1. FOXO1 and S1P1 show a higher expression level in thymoma with myasthenia gravis or thymic hyperplasia, shows FOXO1 and S1P1 are related to the pathogenesis of myasthenia gravis. But in the thymoma and thymic hyperplasiam, the distribution of FOXO1 and S1P1 expression is different, shows that their pathogenic mechanism is different.2. FOXO1 and S1P1 are highly expressed in thymoma, shows that they may are related to the occurrence of tumor, but the specific relationship still needs further research.3. With high expression of FOXO1 and S1P1, peripheral blood CD4 ~+ T cells and the CD4 ~+ / CD8 ~+ T cell ratio also increase, indicating that FOXO1 and S1P1 together take part in T lymphocytes output process with thymic epithelial cells in thymoma with myasthenia gravis.4. Looking at the results from peripheral blood, high expression of CD4 ~+ T cells or low expression of CD8 ~+ T cells destroys CD4 ~+ / CD8 ~+ T cell balance, that perhaps induce MG occurred, but further research is necessary. |
