| Objectives To detect the expression levels of liver regenerative phosphatase-3（PRL-3）,non-catalytic region tyrosine kinase 1（NCK1）,signal transduction and transcriptional activation factor 3（STAT3）and vascular endothelial growth factor（VEGF）in papillary thyroid carcinoma（PTC）,thyroid adenoma,and normal thyroid tissue.We summarize and analyzed the differences and associations of the expression levels of the four in specimens from patients with different clinicopathological characteristics,and explore the influence of the four in the development,progression and metastasis of thyroid cancer to provide theoretical support for the identification of benign and malignant thyroid tumors,the assessment of patients’prognosis and the exploration of relevant drug targets.Methods 1.115 cases of paraffin-embedded thyroid lesions from patients who underwent surgical treatment in the head and neck surgery department of Tangshan Workers’Hospital,Hebei,China,between September 2019 and October 2020 were included.The cases were divided into 3 groups according to pathological characteristics,including 63 cases in the papillary thyroid cancer group,32 cases in the thyroid adenoma group,and 20 cases in the normal thyroid tissue group.All cases had perfect data and clear pathological diagnosis.2.Immunohistochemistry was used to observe the expression trends of PRL-3,STAT3,NCK1 and VEGF in thyroid tissue cells of three different benign and malignant conditions.3.The case data were collated and statistical methods were used to summarize and analyze the risk factors affecting cervical lymphatic metastasis in PTC patients,and to analyze the relationship between the expression levels of the four and the common clinical and pathological characteristics of PTC patients and the significance of the combined test of the four for the diagnosis of PTC.Results 1.The chi-square test showed that lymphatic metastasis in the central region of PTC patients was associated with the patient’s gender.Logistic regression analysis showed that male,age less than 55 years,and multicentricity of cancer foci were risk factors for lymphatic metastasis in PTC（P<0.05）.2.NCK1 had a positive expression level of 71.43%（45/63）in the PTC group,which was significantly different from the positive expression rate of 31.25%（10/32）in the thyroid adenoma group and 30.00%（6/20）in the normal thyroid tissue.The chi-square test showed that the expression level of NCK1 in patients in the PTC group was strongly correlated with the occurrence of cervical lymph node metastasis.logistic regression analysis showed that the presence of concomitant cervical lymphatic metastasis was a risk factor for NCK1 expression in PTC（P<0.05）.3.The positive expression rate of STAT3 in the PTC group was 65.08%（41/63）,which was significantly higher than the positive expression rate of 28.13%（9/32）in the thyroid adenoma group and 25.00%（5/20）in the normal thyroid tissue group,and the difference was statistically significant.The chi-square test showed that STAT3 expression in patients in the PTC group correlated with tumor diameter size and neck lymph node metastasis.Logistic regression analysis showed that tumor diameter>1 cm and cervical lymph node metastasis were risk factors for STAT3 expression in PTC（P<0.05）.4.The positive expression rate of PRL-3 in the PTC group was 74.60%（47/63）,which was significantly higher than the positive expression rate of 21.88%（7/32）in the thyroid adenoma group and15.00%（3/20）in the normal thyroid tissue group,and the difference was statistically significant.The chi-square test showed that PRL-3 expression was associated with cervical lymph node metastasis in patients with PTC.Logistic regression analysis showed that the presence of concomitant cervical lymphatic metastasis was a risk factor for PRL-3expression in PTC（P<0.05）.5.The positive expression rate of VEGF in the PTC group was 79.37%（50/63）,which was significantly higher than the positive rate of 21.88%（7/32）in the thyroid adenoma group and 20.00%（4/20）in the normal thyroid tissue group,and the difference was statistically significant.The chi-square test showed that the expression of VEGF in the PTC group was strongly correlated with the three indicators of tumor diameter size,cervical lymph node metastasis,and thyroid perineural invasion,and the difference was statistically significant.logistic regression analysis showed that tumor diameter>1cm and the presence of cervical lymphatic metastasis were risk factors affecting VEGF expression（P<0.05）.6.Correlation analysis:the expression of all four in PTC showed two positive correlations,where r S-N=0.483,r S-V=0.584,r S-P=0.391,r N-V=0.477,r N-P=0.324,r P-V=0.268,and the differences were statistically significant（P<0.05）.7.Combined assay:The ROC curve results showed that the area under the curve of the combined assay of the four was AUC=0.863,Youden index=0.663,specificity=88.5%,and sensitivity=77.8%（P<0.05）.The AUC,Youden index and specificity of the combined assay were improved compared with the four assays alone.Conclusions 1.Age less than 55 years,male,and multifocal tumors are independent risk factors for cervical lymphatic metastasis of papillary thyroid cancer,and more aggressive treatment plans should be designed to treat these patients.2.NCK1,STAT3,PRL-3 and VEGF play a role in the development or progression of papillary thyroid cancer,suggesting an increased risk of malignant transformation of thyroid cells.The combination of these four tests can improve the diagnostic efficacy and assess the prognosis of patients by determining their potential risk of metastasis.3.There is a positive synergy between NCK1,STAT3,PRL-3 and VEGF,and they promote lymph node metastasis in papillary thyroid carcinoma,and high expression of all four suggests an increased risk of lymph node metastasis.Figure5;Table19;Reference 121... |
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