The Relationship Between HMGB1,CD68,D2-40 And Cervical Lymph Node Metastasis In Papillary Thyroid Carcinoma

Objectives The research aimed to measure expressions of HMGB1,CD68 and D2-40 in papillary thyroid carcinoma and nodular goiter tissues to investigate the correlation between HMGB1,tumor associated macrophages and lymphatic vessel density in papillary thyroid carcinoma and their association with cervical lymph node metastasis in papillary thyroid carcinoma,providing valuable experimental evidence for the clinical diagnosis and treatment of papillary thyroid carcinoma and the prognosis of patients with papillary thyroid carcinoma.Methods Paraffin embedded tumor tissues of 93 thyroid tumor patients who had been diagnosed and treated in head and neck surgery of Tangshan Gongren Hospital in Hebei was selected.31 cases were nodular goiter tissues,62 cases were papillary thyroid carcinoma tissues.Of the 62 papillary thyroid carcinoma patients,there were 31 cases with cervical lymph node metastasis,and the other was not associated with cervical lymph node metastasis in 31 cases.Immunohistochemical SP method was used to detect the expressions of HMGB1,CD68 and D2-40 in papillary thyroid carcinoma and nodular goiter tissues.Results 1 Positive expression rate of HMGB1 has significant difference between the two groups(P<0.05)while it was 61.29% in papillary thyroid carcinoma group,significantly higher than the positive expression rate of 22.58% in nodular goiter group.In papillary thyroid carcinoma group there was no significant difference in HMGB1 expression level between different age and gender groups(P>0.05),while there was significant difference(P<0.05)that positive expression rate in the group with cervical lymph node metastasis of 80.65% was significantly higher than that in the group without cervical lymph node metastasis of 41.94%.2 Positive expression rate of CD68 has significant difference between the two groups(P<0.05)while it was 70.97% in papillary thyroid carcinoma group,significantly higher than the positive expression rate of 16.13% in nodular goiter group.In papillary thyroid carcinoma group there was no significant difference in CD68 expression level between different age and gender groups(P>0.05),while there was significant difference(P<0.05)that positive expression rate in the group with cervical lymph node metastasis of 87.10% was significantly higher than that in the group without cervical lymph node metastasis of 54.84%.3 The expression level of D2-40 in papillary thyroid carcinoma(12.45±6.29)was much higher than that in nodular goiter(3.58±3.11),and the difference between the two groups was statistically significant(P<0.05).In papillary thyroid carcinoma group there was no significant difference in D2-40 expression level between different age and gender groups(P>0.05),while there was significant difference(P<0.05)that the expression level of D2-40 in the group with cervical lymph node metastasis(14.95±7.05)was significantly higher than that in the group without cervical lymph node metastasis(9.95±4.22).4 Correlationship of the expression levels of HMGB1,CD68 and D2-40 in papillary thyroid carcinoma: The expression level of HMGB1 was positively correlated with the expressions level of CD68(r=0.384,P<0.05).The expression level of HMGB1 was positively correlated with the expressions level of D2-40(r=0.428,P<0.05).The expression level of CD68 was positively correlated with the expressions level of D2-40(r=0.479,P<0.05).Conclusions 1 The expression levels of HMGB1,CD68 and D2-40 in papillary thyroid carcinoma tissues were significantly higher than those in nodular goiter(P<0.05).All of them play important roles in the occurrence and development of papillary thyroid carcinoma.2 The expression levels of HMGB1,CD68 and D2-40 were significantly correlated with cervical lymph node metastasis(P<0.05).It can be concluded that the three factors are involved in the process of cervical lymph node metastasis of thyroid papillary carcinoma,which can be used as a reference index to evaluate the metastasis of thyroid papillary carcinoma.3 Spearman correlation analysis showed that there was a significant correlation between the expression levels of HMGB1,CD68 and D2-40 as there was a positive correlation between them(P<0.05).This confirms that there is a close connection between them.In the course of papillary thyroid carcinoma,HMGB1 not only activated TAMs,but also directly involved in the formation of lymphatic vessels.TAMs are involved in the development of papillary thyroid carcinoma by promoting the proliferation of cancer cells,and play an important role in the formation and proliferation of lymphatic vessels.After the interaction of HMGB1 and TAMs,the number of lymphatic vessels in tumor tissue was increased which directly involved in the promotion of cervical lymph node metastasis of papillary thyroid carcinoma.