Liu Jia, Chen Guang, Meng Xian-Ying, Liu Zhong-Hui, Dong Su
Department of Thyroid Surgery, First Hospital of Jilin University, Changchun 130021, China.
Department of Immunology, Norman Bethune College of Medicine, Jilin University, Changchun 130021, China.
Pathol Res Pract. 2014 Dec;210(12):830-5. doi: 10.1016/j.prp.2014.09.002. Epub 2014 Sep 18.
Previous studies have demonstrated the expression of estrogen receptor (ER) and progesterone receptor (PR) in thyroid cancer; however, little is known regarding the levels of estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH) in serum and the expression of ER, PR, FSH receptor (FSHR), and LH receptor (LHR) in thyroid tissues of patients with different types of thyroid neoplasms. Serum levels of estrogen, progesterone, FSH, and LH were measured by chemiluminescence, and expression of ER, PR, FSHR, and LHR in thyroid tissue was detected by immunohistochemistry in female patients with thyroid adenoma (n = 70), nodular goiter (n = 73), thyroid papillary cancer (n = 149), poorly differentiated thyroid carcinoma (n = 12), or undifferentiated thyroid carcinoma (n = 8) and in normal controls (n = 60). The positive rates of serum estrogen level and ERα expression were significantly greater in patients with various types of thyroid neoplasms than in normal controls. The positive rates of ERβ expression were significantly less in various types of thyroid neoplasms than in normal thyroid tissues, especially in poorly differentiated carcinoma and undifferentiated carcinoma. The negative rates of serum progesterone level and positive rates of PR expression in thyroid tissue were significantly greater in patients with thyroid adenoma, nodular goiter, or thyroid papillary cancer than in normal controls. The positive rates of serum FSH and LH levels and FSHR and LHR expression were significantly greater in the thyroid adenoma group than in other groups. Our findings suggest that thyroid neoplasms might be sex hormone-dependent. The positive expression of ERα and PR often indicates thyroid papillary carcinoma, and the ERβ expression status is important for the diagnosis of poorly differentiated carcinoma and undifferentiated carcinoma. In addition, thyroid adenoma is often accompanied by an increase in serum FSH and LH levels, as well as FSHR and LHR expression. Thus, the combined detection of serum levels of sex hormones and expression of their receptors allows for a differential diagnosis and evaluation of the degree of differentiation among various types of thyroid neoplasms.
以往研究已证实甲状腺癌中存在雌激素受体（ER）和孕激素受体（PR）的表达；然而，对于不同类型甲状腺肿瘤患者血清中雌激素、孕激素、促卵泡生成素（FSH）和黄体生成素（LH）的水平，以及甲状腺组织中ER、PR、FSH受体（FSHR）和LH受体（LHR）的表达情况，人们了解甚少。采用化学发光法测定女性甲状腺腺瘤患者（n = 70）、结节性甲状腺肿患者（n = 73）、甲状腺乳头状癌患者（n = 149）、低分化甲状腺癌患者（n = 12）、未分化甲状腺癌患者（n = 8）及正常对照者（n = 60）血清中雌激素、孕激素、FSH和LH的水平，并通过免疫组织化学法检测甲状腺组织中ER、PR、FSHR和LHR的表达。各类甲状腺肿瘤患者血清雌激素水平及ERα表达的阳性率显著高于正常对照者。各类甲状腺肿瘤中ERβ表达的阳性率显著低于正常甲状腺组织，尤其是在低分化癌和未分化癌中。甲状腺腺瘤、结节性甲状腺肿或甲状腺乳头状癌患者血清孕激素水平的阴性率及甲状腺组织中PR表达的阳性率显著高于正常对照者。甲状腺腺瘤组血清FSH和LH水平及FSHR和LHR表达的阳性率显著高于其他组。我们的研究结果表明，甲状腺肿瘤可能与性激素有关。ERα和PR的阳性表达常提示甲状腺乳头状癌，ERβ的表达状态对低分化癌和未分化癌的诊断具有重要意义。此外，甲状腺腺瘤常伴有血清FSH和LH水平以及FSHR和LHR表达的升高。因此，联合检测血清性激素水平及其受体的表达有助于对各类甲状腺肿瘤进行鉴别诊断及评估分化程度。
