Liu Xingkai, Su Chang, Xu Jing, Zhou Dan, Yan He, Li Wei, Chen Guihui, Zhang Nan, Xu Dahai, Hu Haixia
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
Department of Thyroid Surgery, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China.
Oncol Lett. 2019 Feb;17(2):2308-2316. doi: 10.3892/ol.2018.9850. Epub 2018 Dec 19.
The present study aimed to explore the association between immunohistochemical matrix metalloproteinase-9 (MMP-9) expression and the clinicopathological characteristics of patients with papillary thyroid carcinoma (PTC), and to determine whether it may be used as a diagnostic or prognostic tool for PTC. Immunohistochemical staining of MMP-9 was performed in thyroid tissues obtained from 112 patients with PTC and 42 subjects with benign thyroid nodules (BTNs). The receiver operating characteristic curve was used to evaluate the legitimacy of MMP-9 as a diagnostic tool for PTC, and a predictor for structurally persistent/recurrent disease (SPRD) and disease status. Cox regression was applied to identify the risk factors of disease status and SPRD. The present study revealed that MMP-9 was overexpressed in PTC tissues, compared with in BTN tissues. Furthermore, MMP-9 scores yielded an area under the curve (AUC) of 0.842 (95% CI, 0.776-0.908) for differentially diagnosing PTC from BTN. In addition, the MMP-9 score was greater if patients previously had central lymph node metastasis, lateral lymph node metastasis or an advanced tumor-node-metastasis stage (III+IV). When MMP-9 was employed to predict disease status and SPRD, an AUC of 0.811 (95% CI, 0.706-0.917) and 0.806 (95% CI, 0.620-0.992) was obtained, respectively. A tumor size of >2 cm and an MMP-9 staining score of ≥6 were independent risk factors for predicting disease status, whereas vascular invasion and an MMP-9 staining score of ≥8 were risk factors for predicting SPRD. Furthermore, an MMP-9 staining score of ≥6 and ≥8 indicated shortened disease-free survival and survival without SPRD, respectively. In conclusion, the assessment of MMP-9 expression in thyroid carcinoma samples may represent a potential and supplementary tool for the diagnosis and prognostic prediction of PTC.
本研究旨在探讨免疫组织化学检测基质金属蛋白酶-9（MMP-9）表达与甲状腺乳头状癌（PTC）患者临床病理特征之间的关联，并确定其是否可作为PTC的诊断或预后工具。对112例PTC患者和42例甲状腺良性结节（BTN）患者的甲状腺组织进行MMP-9免疫组织化学染色。采用受试者工作特征曲线评估MMP-9作为PTC诊断工具的合理性，以及作为结构持续性/复发性疾病（SPRD）和疾病状态预测指标的合理性。应用Cox回归分析确定疾病状态和SPRD的危险因素。本研究显示，与BTN组织相比，MMP-9在PTC组织中过表达。此外，MMP-9评分在鉴别诊断PTC与BTN时的曲线下面积（AUC）为0.842（95%CI，0.776-0.908）。此外，如果患者既往有中央淋巴结转移、侧方淋巴结转移或处于晚期肿瘤-淋巴结-转移分期（III+IV期），则MMP-9评分更高。当用MMP-9预测疾病状态和SPRD时，AUC分别为0.811（95%CI，0.706-0.917）和0.806（95%CI，0.620-0.992）。肿瘤大小>2 cm和MMP-9染色评分≥6是预测疾病状态的独立危险因素，而血管侵犯和MMP-9染色评分≥8是预测SPRD的危险因素。此外，MMP-9染色评分≥6和≥8分别提示无病生存期缩短和无SPRD生存期缩短。总之，评估甲状腺癌样本中MMP-9的表达可能是PTC诊断和预后预测的一种潜在辅助工具。
