Herac Merima, Niederle Bruno, Raderer Markus, Krebs Michael, Kaserer Klaus, Koperek Oskar
Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria.
Section of Endocrine Surgery, Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
APMIS. 2016 Oct;124(10):839-45. doi: 10.1111/apm.12584. Epub 2016 Aug 19.
Medullary carcinoma (MTC) is an aggressive tumour that derives from the thyroid parafollicular calcitonin-secreting cells (C cells). Lymph node metastasis may occur early in disease pathogenesis and is one of the most important negative prognostic parameters. Surgery is the only curative therapy while chemotherapeutic options are limited. Neuroendocrine differentiated C cells may express somatostatin receptors (SSTR), which have a wide range of biological actions including inhibitory effects on cell survival and angiogenesis and antiproliferative effects on cancer cell lines. Moreover, they are a potential target for various somatostatin analogues. Aim of this study was to analyse the protein expression of SSTR2A and 5 in MTCs with or without the presence of lymph node metastases in correlation with various clinicopathological parameters. This retrospective immunohistochemical analysis included 97 patients with medullary thyroid carcinomas. Protein expression was detected by immunohistochemistry for somatostatin receptors 2A and 5. Various clinicopathological parameters, such as Ki-67 proliferation index or presence of desmoplasia, were included for statistical analysis. SSTR2A protein expression significantly correlated with the presence of lymph node metastases (p = 0.009), locally advanced MTCs staged according to the TNM (p < 0.001) and degree of desmoplasia (p = 0.029). Although SSTR5 protein expression significantly correlated with advanced stages of MTCs (p = 0.023) and degree of desmoplasia (p = 0.020), no correlation was found with the presence of lymph node metastases. Our results provide additional information concerning the aggressiveness of MTCs and reveal that a high SSTR2A and SSTR5 expression might be a poor prognostic feature.
髓样癌（MTC）是一种侵袭性肿瘤，起源于甲状腺滤泡旁分泌降钙素的细胞（C细胞）。淋巴结转移可能在疾病发病早期出现，是最重要的不良预后参数之一。手术是唯一的治愈性疗法，而化疗选择有限。神经内分泌分化的C细胞可能表达生长抑素受体（SSTR），其具有广泛的生物学作用，包括对细胞存活和血管生成的抑制作用以及对癌细胞系的抗增殖作用。此外，它们是各种生长抑素类似物的潜在靶点。本研究的目的是分析有或无淋巴结转移的MTC中SSTR2A和5的蛋白表达，并与各种临床病理参数相关联。这项回顾性免疫组织化学分析纳入了97例甲状腺髓样癌患者。通过免疫组织化学检测生长抑素受体2A和5的蛋白表达。纳入各种临床病理参数，如Ki-67增殖指数或纤维组织形成情况，进行统计分析。SSTR2A蛋白表达与淋巴结转移的存在显著相关（p = 0.009），与根据TNM分期的局部晚期MTC显著相关（p < 0.001），与纤维组织形成程度显著相关（p = 0.029）。虽然SSTR5蛋白表达与MTC的晚期阶段显著相关（p = 0.023）和纤维组织形成程度显著相关（p = 0.020），但与淋巴结转移的存在未发现相关性。我们的结果提供了有关MTC侵袭性的更多信息，并揭示高SSTR2A和SSTR5表达可能是不良预后特征。
