Expression And Significance Of Pax8-PPARγ Gamma In Differentiated Thyroid Carcinoma In Qingdao

Objective:Thyroid carcinoma is the most common endocrine malignancy,and the incidence of thyroid carcinoma has more than doubled since 1990.Differentiated thyroid carcinomas(DTC)account for more than 90% of thyroid carcinomas(TC)and the majority of growth rate of thyroid cancer.At present,the diagnosis methods for thyroid nodules include thyroid ultrasound,neck CT and fine needle aspiration biopsy(FNAB)and so on.It is very important that accurate preoperative diagnosis of thyroid nodules to provide the most appropriate clinical treatment for these patients and to avoid overtreatment.Although fine-needle aspiration(FNA)followed by cytologic examination is the most common and effective diagnostic tool,approximately 25% of FNAs cytology yield an indeterminate diagnosis.Surgical treatment of these undiagnosed nodules was performed,and the postoperative pathology showed that 20-25% was thyroid cancer,but 75-80% received unnecessary surgery.Molecular testing for genetic mutations has been shown to enhance the accuracy of thyroid FNA cytology,particularly incases of indeterminate cytology.With the development of molecular biology,the study of thyroid cancer at the molecular level has been paid increasing attention.So far,BRAF gene mutation,RET/ PTC recombination,RAS point mutation,Na+/I-Symporter(NIS)gene mutation and PAX8/PPARγ gene rearrangement have been found a certain relationship with thyroid carcinoma.This study was to analyze the expression of Pax8-PPARγ rearrangement gene in patients with differentiated thyroid cancer(DTC)in Qing Dao area,and evaluate the clinicopathological characteristicsto provide some theory for gene diagnosis,gene therapy and prognosis of DTC patients.Methods:All the selected thyroid tissues were excised by surgery,and the pathological diagnosis was performed by the experienced pathologist.The expression of the Pax8-PPARγ rearrangement gene in the DTC and the nodular goiter(benign tumor)was detected by PCR amplification.There are 60 FTC patients、60 PTC patients、60 nodular goiter patients who underwent therapy in the Department of General Surgery,The Affiliated Hospital of Qingdao University from Jan 2015 to July 2016.Observe the difference between the different clinicopathological characteristics.Results:The expression of the Pax8-PPARγ rearrangement gene in FTC is obviously higher than PTC and the nodular goiter(p<0.05).The expression of the Pax8-PPARγrearrangement gene in DTC would be more aggressively in capsular invision and vascularinvision(p<0.05).But,there are no significance in gender、age and lymphatic metastasis(p>0.05)In this study,distant metastasis occurred in 5 cases,including 3 cases of lung metastases and 2 cases of bone metastases,which may be related to the increased invasiveness of tumors caused by the fusion gene in these cases.Conclusions:The expression of Pax8-PPAR gamma fusion gene in differentiated thyroid carcinoma has significant difference,that is,the positive expression of the fusion gene in follicular thyroid carcinoma is significantly higher than that in papillary thyroid carcinoma.Moreover,the expression of positive follicular thyroid cancer is more aggressive.It indicates that follicular thyroid carcinoma with positive expression of Pax8-PPAR gamma fusion gene has higher membrane invasion and vascular invasion tendency.Pax8-PPARγ gene rearrangement gene could be the molecular marker in differentiated thyroid cancer,especially in FTC,and be valuable to the therapy and prognosis of FTC.