Pesutić-Pisac Valdi, Punda Ante, Gluncić Ivo, Bedeković Vladimir, Pranić-Kragić Anka, Kunac Nenad
Clinical Department for Pathology, Clinical Hospital Split, Dubrovacka 18, 21000 Split, Croatia.
Croat Med J. 2008 Oct;49(5):643-9. doi: 10.3325/cmj.2008.5.643.
To determine the prognostic value of cell cycle regulators cyclin D1 and p27 for papillary thyroid carcinomas.
Analysis included 180 patients with papillary thyroid carcinoma who underwent surgery at Split University Hospital Center between 1999 and 2001. Clinical data were obtained from clinical charts and histopathology reports. Immunohistochemistry was performed on formalin-fixed, paraffin-embedded tissue by antibody p27 and cyclin D1. Quantification was based on the intensity and distribution of nuclear staining.
Univariate analysis showed that sex (P=0.019) and capsular invasion (P=0.010) were significant predictors of lymph node metastases, whereas age (P=0.96), histopathological variant (P=0.075), size (P=0.556) and multifocality (P=0.131) were not. Univariate analysis also showed that overexpression of cyclin D1 (P<0.001) and underexpression of p27 (P<0.001) predicted lymph node metastases in papillary thyroid carcinomas. There was a significant correlation between cyclin D1 (P=0.024) and p27 (P=0.029) expression in two prognostic groups of low and high risk. Low risk group was cyclin D1 negative and p27 positive, while high risk group was cyclin D1 positive and p27 negative. Multivariate analysis confirmed that sex (P=0.041), capsular invasion (P=0.027), and p27 (P<0.001) were strong independent predictors of lymph node metastases in the high-risk group.
Immunohistochemical analysis of p27 expression may be a valuable tool for identifying risk of lymph node metastases and more aggressive behavior of papillary thyroid carcinoma.
确定细胞周期调节因子细胞周期蛋白D1和p27对甲状腺乳头状癌的预后价值。
分析了1999年至2001年间在斯普利特大学医院中心接受手术的180例甲状腺乳头状癌患者。临床数据来自临床病历和组织病理学报告。采用p27和细胞周期蛋白D1抗体对福尔马林固定、石蜡包埋的组织进行免疫组织化学检测。定量基于核染色的强度和分布。
单因素分析显示，性别（P=0.019）和包膜侵犯（P=0.010）是淋巴结转移的显著预测因素，而年龄（P=0.96）、组织病理学变异（P=0.075）、肿瘤大小（P=0.556）和多灶性（P=0.131）不是。单因素分析还显示，细胞周期蛋白D1过表达（P<0.001）和p27低表达（P<0.001）可预测甲状腺乳头状癌的淋巴结转移。在低风险和高风险两个预后组中，细胞周期蛋白D1（P=0.024）和p27（P=0.029）表达之间存在显著相关性。低风险组细胞周期蛋白D1阴性且p27阳性，而高风险组细胞周期蛋白D1阳性且p27阴性。多因素分析证实，性别（P=0.041）、包膜侵犯（P=0.027）和p27（P<0.001）是高风险组淋巴结转移的强独立预测因素。
p27表达的免疫组织化学分析可能是识别甲状腺乳头状癌淋巴结转移风险和更具侵袭性生物学行为的有价值工具。
