| Objectives: In recent years, the incidence of thyroid cancer is growing. One of the most common is papillary thyroid carcinoma(papillary thyroid carcinoma, PTC), accounting for about 80% of thyroid cancer. Although the PTC prognosis is good, but the recurrence rate is as high as 35%. Clinical observation, invasive strong PTC subtypes, the recurrence rate is high. So PTC recurrence may be associated with the treatment scheme and pathological subtype of PTC. Most clinical doctors agree to the multimodality treatment including surgical operation, 131 I and endocrine therapy. Endocrine namely thyrotropin(TSH) suppressive therapy, plays the key role in reducing the differentiated thyroid cancer reurrence. Up till now, the extent of surgery, the efficacy and necessity of endocrine is still controversial. A retrospective study said TSH suppression therapy has no obvious difference with the recurrence rate of patients with PTC. Related research said thyroid cancer TSHR expression and function related to TSH suppression effect. And endocrine has many side effects, the serious influence the PTC patients survival time and and quality of life. So explore the TSHR expression of PTC, the implementation of PTC individal treatment of patients is imminent. This study was designed to measure the expression of TSHR in PTC pathological subtypes, evaluation of PTC clinical parameter, such as gender, age, neck lymph node metastasis and histological staging and the correlation of TSHR, and offer evidence to make individuation treatment plan.Methods:To collect 108 papillary thyroid carcinoma medical records of Thyroid Surgery Department in hebei medical university east campus in March, 2014- September, 2014, it has ruled out patients who received theatment associated with thyroid disease. We take the 108 archive wax blocks in pathology department, another 42 cases thyroid tissue, which is more than 1cm distance from the adenoma, as a control group. All thyroid tissue wax blocks were cut into 3 pieces of 4?m thickness of section 3 copies, one for conventional HE staining,further classification of subtypes according to the pathological morphological observation, the other two slices for TSHR immunohistochemical staining and the negative control, for each cases confirmed by above two pathology physicians. Using SP method to text the level of TSHR in thyroid papillary carcinoma subtypes, and analysing the correlation with the clinical related parameters. SPSS 21.0 statistical software was used for data analysis from chi-square, nonparametric rank test methods. Inspection standard for P<0.05 was statistically significant.Results: 1 PTC pathological morphology observation and subtype classification Method Normal tissue stain was used to observe the morphological features of PTC. The experiment of 108 cases of PTC slices, classic papillary carcinoma for 40 cases, 37 cases of thyroid papillary carcinoma, PTC follicular subtype for 13 cases, PTC acidophilus subtype for 12 cases, PTC with island differentiation, a total of 4 cases, diffuse sclerosis type 2 case. With island differentiation and diffuse slerosis subtypes are collectively refferred to as invasive subtypes.2 Clinical parameters analysis of PTCAnalyzing the clinical data of 108 patients with PTC, 1) sex: male 26 cases, 82 cases of female, male female material 1:3. 2) age: patients aged 13 to 80 years. 3) treatment: according to intraoperative frozen pathological tips for “PTC”, carries out thyroid cancer radical prostatectomy. 4) the central lymph node metastasis: 61 cases of positive transfer,percentage material 56.48%(61/108),aggressive subtype of the central region of lymph node metastasis rate was 100%.3 The expression of TSHR situationTSHR expression in normal thyroid tissue positive rate was 100%, positive and strong positive rate was 80.95%. TSHR expression postive rate was 86.11% in 108 cases patients of PTC, positive and strong positive rate(49.07%); Positive rate was 85.00% in 40 cases of classical PTC, positive and strong positive expression rate(40.00%); Positive rate was 94.59% in 37 cases of PTC tiny subtypes, positive and strong positive expression rate(72.97%); Positive rate was 84.61% in 13 patients with PTC follicular subtypes, positive and strong positive expression rate(38.46%); 12 cases of PTC acidophilus subtypes were 83.33%, positive and strong positive expression rate(33.33%); 6 cases of PTC affects subtypes were 50.00%, positive and strong positive rate was 16.67%. Kruskal Wallis H-inspection for 5 sets of data was statistically significant, can be thought of PTC this 5 kinds of pathological types of TSHR is distinct. Further application of Wilcoxon rank and inspection of the typical, miniature, follicular, acidophilus, hit with peritumoral normal thyroid tissue subtype are compared, there was significant difference in the level of expression of TSHR between five and tumor adjacent normal thyroid tissuse pairwise, we can think that the expression of TSHR in tumor adjacent normal thyroid tissue was higher than that of different pathological types, and the expression of tiny subtype was higher than the other subtypes, the difference between other subtypes was no statistical significance. TSHR positive rate of noninvasive subtypes is 88.24%; TSHR positive rate of invasive subtypes was 50%,the difference between the teo groups was statistically significant, so we can think the expression of TSHR in noninvasive subtypes is higher than in invasive subtypes.4 TSHR expression relations with PTC clinical relevant factorsPTC according to TNM staging can be observed: ?period in 72 patients, the positive expression rate is 86.11%; ?period in 5 cases, the positive expression rate is 80.00%; ?period in 27 cases, positive expression rate is 88.89%; period in 4 cases,? positive expression rate is 75.00%. Use Kruskal Wallis H-inspection, no statistical significance between the four groups, the correlation between clinical stage of PTC and the expression of TSHR was not considere.In addition, it compares the relationship of lymph node metastasis, tumor stage, patient' gender, age with the expression of TSHR. It can't think the expression of TSHR related to these factors.Conclusion:1 The expression of TSHR in normal thyroid tissue is stronger than PTC, which is better in tiny subtype than other pathological types, no statistical differences in other pathological types.2 The expression of TSHR in noninvasive PTC subtypes is stronger than aggressive subtype.3 No relationship was found between the expression of TSHR and sex, age, lymph metastasis or pathology stage. |
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