| Objective: Our pervious study including clinical data analysis,found that thyroid papillary micro carcinoma can occur early lymph node metastasis.In this study,the expression of MDM2 and PTEN in different thyroid tissues was detected by Western blotting and immunohistochemistry.To analyze the effects of these two indicators on the occurrence and development of thyroid papillary micro carcinoma,and to explore the relationship between the two indicators in depth.To provide a theoretical basis for the pathogenesis of PTMC,and provide help for the early diagnosis,targeted therapy and prognosis.Methods:1 Clinical data was medical records from inpatients who has hospitalized in our department from January 2014 to July 2016 in Hebe General hospital,to analysis the incidence of thyroid papillary micro carcinoma and lymph node metastasis.2 In this test,we chose 15 cases of surgical resection of frozen specimens taken from inpatients who was hospitalized in our department from January 2014 to July 2016 in Hebe General hospital,including thyroid benign tumor tissue in 5 cases,thyroid papillary micro carcinoma without lymph node metastasis in 5 cases,thyroid papillary micro carcinoma with lymph node metastasis in 5 cases,The expression of MDM2 and PTEN protein in three groups was detected by Western blot and the correlation was analyzed by SPSS;And we choose 109 cases of surgical resection of paraffin specimens taken from inpatients who was hospitalized in our department from January 2014 to July 2016 in Hebe General hospital,by two experienced pathologists confirmed including 20 cases of normal thyroid tissue,thyroid benign tumor tissue in 32 cases,thyroid papillary micro carcinoma without lymph node metastasis in 24 cases,thyroid papillary micro carcinoma lymph node metastasis in 33 cases,use the immunohistochemical method,the expression of MDM2 and PTEN protein in thyroid tissue was detected and the correlation was analyzed by SPSS.To study the relationship and clinical significance of two indicators in the thyroid papillary micro carcinoma process and development.3 SPSS 21.0 statistical software was used for statistical analysis,and it is the statistically significant when P<0.05.Result:1 The total number was 1020 cases,349 cases of malignant cases,accounting for 34.22% of all cases,of which 334 cases of thyroid papillary carcinoma accounted for 95.70% of all malignant cases,thyroid papillary micro carcinoma 151 cases,accounting for 45.21% of all papillary carcinoma,there were 138 cases of micro cancer get on? area lymph node dissection,positive in 70 cases,the ? area of lymph node metastasis rate of 50.72%,52 cases of lateral cervical lymph node dissection,of which ?area 13 cases of lymph node metastasis,positive rate was 25.00%,?area 19 cases of lymph node metastasis,positive rate was 36.54%,?area 18 cases of lymph node metastasis,positive rate was 34.62%,?area cases of lymph node metastasis,positive rate was 5.77%.2 Western blot results2.1 The expression of MDM2 in thyroid papillary micro carcinoma was significantly higher than that in benign thyroid tissue,and in the papillary thyroid micro carcinoma group lymph node metastasis was higher than that in the non-lymph node metastasis group,the difference was statistically significant(P <0.05).2.2 The expression of PTEN in thyroid papillary micro carcinoma was significantly lower than that in benign thyroid tissue,and in the papillary thyroid microcarcinoma group lymph node metastasis was lower than that in the non-lymph node metastasis group,the difference was statistically significant(P <0.05).2.3 There was a negative correlation between the expression of MDM2 protein and PTEN protein in thyroid tissue,and the correlation between the two indexes was linear negative correlation,Pearson correlation coefficient r=-0.991,P <0.05.3 Immunohistochemical results3.1 MDM2 was mainly expressed in the nucleus of thyroid cancer tissue,the expression in cytoplasm less than the nucleus,cell membrane almost no expression,in this study the expression in cytoplasm and nucleus was the positive expression,cell membrane as ectopic expression.PTEN was mainly expressed in the normal cytoplasm of the thyroid,the nucleus also had a small amount of expression,this experiment will be expressed in the nucleus and cytoplasm of PTEN protein as positive expression.3.2 The positive expression rate of MDM2 in normal thyroid tissue was 20%,the positive rate of MDM2 in benign thyroid tumor was 34.4%,the positive rate of MDM2 in thyroid papillary micro carcinoma was 100%.The expression of MDM2 protein in thyroid papillary micro carcinoma was significantly higher than that in thyroid normal tissues and thyroid benign masses,?2=62.534,P <0.05,which was statistically significant.There was no significant difference in the expression of MDM2 protein between thyroid normal tissues and benign tumor tissues(P > 0.05).The expression of MDM2 in thyroid papillary micro carcinoma was not significantly correlated with age,sex and tumor invasion.The positive rate of MDM2 was 40.7% in lymph node metastasis group.The positive rate of MDM2 was 69.7% in lymph node metastasis group,and P <0.05,the difference was statistically significant.The positive expression rate of PTEN in normal thyroid tissue was 100%,the positive expression rate in benign thyroid tissue was 96.9% and 28.1% in thyroid papillary micro carcinoma.The expression of PTEN in normal thyroid tissue and benign tumor tissue was significantly higher than that in thyroid carcinoma tissues,?2=56.319,P <0.05,the difference was statistically significant,but there was no significant difference between normal tissue and benign tumor tissue.The expression of PTEN protein in thyroid papillary micro carcinoma was not correlated with sex,and lymph node metastasis.The positive expression rate of PTEN in thyroid carcinoma was 60.0% in the group of <45 years old,10.8% in the patients?45 years old,and P<0.05,the difference was statistically significant;The positive expression rate of PTEN protein in thyroid papillary micro carcinoma was 43.2% in the non-invasive group and 0% in the invasive group and P<0.05,the difference was statistically significant.3.3 There was a negative correlation between the expression of MDM2 protein and PTEN protein in thyroid carcinoma,and the Spearman rank correlation coefficient r=-0.556,P <0.05.Conclusion:1 The high expression of MDM2 plays an important role in the development of thyroid papillary micro carcinoma and lymph node metastasis.2 The decrease of PTEN expression plays an important role in the development of thyroid papillary micro carcinoma.The decrease of PTEN expression can further promote the metastasis and invasion of tumor.3 MDM2 and PTEN proteins may play an important role in the development of thyroid papillary carcinoma through the signal transduction pathways.The combination of two markers can help the early diagnosis,surgical choice,recurrence and metastasis prognosis risk assessment of papillary thyroid micro carcinoma. |
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