The Expression And Significance Of CCR5 In Papillary Thyroid Carcinoma With Hashimoto's Thyroiditis

Objective:Thyroid carcinoma(TC)is one of the most common malignant tumors in the head and neck and endocrine system of the human body.In recent years,with the change of people's living environment and lifestyle,the incidence of TC is increasing year by year.The incidence of TC combined with Hashimoto's thyroiditis(HT)is also increasing.The most common is papillary thyroid carcinoma combined with Hashimoto's thyroiditis(HT-PTC).Differentiated thyroid cancer has a high rate of lymph node metastasis.The way of operation and the scope of lymph node dissection are of great significance for the treatment of differentiated thyroid cancer.The clinicopathological features of HT-PTC are somewhat different from that of PTC alone.HT-PTC patients by means of auxiliary examination to determine the central lymph node metastasis is difficult.CC chemokine receptor 5(CCR5)is a cell membrane protein,which has been proved to be expressed in thyroid papillary carcinoma(PTC),and has a promoting effect on the occurrence and development of PTC,and lymph node metastasis.However,its expression in HT-PTC has not been reported in related literatures.In this study,the expression of chemokine receptor 5 in HT-PTC tissue and other pathological types of thyroid tissue was detected.Objective to explore the correlation between CCR5 and HT-PTC,further combine with other pathol ogical data analysis,and find predictors of lymph node metastasis tendency in HT-PTC patients,so as to improve the accuracy of preoperative evaluation and to develop more reasonable treatment plan for patients.Methods:According to the inclusion criteria,a total of 215 paraffin specimens of thyroid papillary carcinoma from January 1,2016 to May 31,2017 were selected from a treatment group of Liaocheng People's Hospital.The paraffin specimens of 46 cases of patients with HT-PTC were divided into experimental group A,the remaining 169 cases of PTC paraffin specimens were divided into experimental group B,30 cases of adjacent thyroid tissue specimens(more than 2cm away from the tumor edge)as control group C,randomly selected 30 paraffin specimens of nodular goiter.As another control group D.Respectively,the clinical data and pathological data of four cases were collected,including age,gender,pathological stage,tumor size,capsule invasion,central cervical lymph node metastasis,number of lesions.The expression of CCR5 in paraffin specimens of each group was detected by immunohistochemical method.Spss20.0 was applied to analyze the expression results of CCR5 in each group,combined with their lymph node metastasis and clinicopathological characteristics,and to find out the rule of statistics.Results:1.There were 30 men and 185 women in 215 PTC patients.The proportion of men and women is 1:6.2.There were 46 patients in HT-PTC,accounting for 21.4% of the total.PTMC patients accounted for 55.8% of the total.The central lymph node metastasis rate was 52.1%,the invasion of the membrane was 61.4%.2.In group HT-PTC,there were 18 central lymph node metastasis,the metastasis rate was 39.1%.In PTC group,there were 94 cases with lymph node metastasis,the metastasis rate was 55.6%.Compared with PTC group,HT-PTC group had a lower incidence of early age,tumor stage,low lymph node metastasis rate.The difference was statistically signifycant(P<0.05).3.The positive expression rate of CCR5 in all PTC patients was 55.8%,which was higher than para cancerous tissue(23.3%)and nodular goiter(13.3%).The positive expression rate of CCR5 in group HT-PTC was 39.1%,and the positive expression rate of CCR5 in group PTC was 60.4%.The positive expression rate of CCR5 in HT-PTC group was lower than simple PTC group,the difference was significant(P<0.05).4.In the HT-PTC group,the CCR5 positive patients with central lymph node metastasis rate(61.1%)was significantly higher than that of CCR5 negative patients(25%),the difference was statistically significant(P<0.05);In the simple PTC graup,the lymph node metastasis rate of CCR5 positive patients(61.8%)was higher than CCR5 negative patients(46.3%),the difference was statistically significant(P<0.05).5.The positive expression of CCR5 in both HT-PTC group and simple PTC group were not correlate with age,sex,and TNM stage(P>0.05),which were associated with lymph node metastasis(P<0.05).Conclusion:1.Compared with the group of simple PTC,the HT-PTC group had a lower central lymph node metastasis rate,which suggests a better prognosis.2.The expression of CCR5 was related to the occurrence,progression and lymph node metastasis of HT-PTC.The negative expression of CCR5 can be used as a predictor of negative lymph node metastasis in central area of HT-PTC patients.3.The inflammatory microenvironment of HT may affect the occurrence and development of PTC by reducing the expression of CCR5 in cancer cells.