Department of Endocrinology, General Hospital of Central Theater Command, Wuhan.
Southern Medical University, Guangzhou.
Eur J Histochem. 2023 Mar 20;67(2):3622. doi: 10.4081/ejh.2023.3622.
Papillary thyroid carcinoma (PTC) is the most common thyroid malignancy. However, it is very difficult to distinguish PTC from benign carcinoma. Thus, specific diagnostic biomarkers are actively pursued. Previous studies observed that Nrf2 was highly expressed in PTC. Based on this research, we hypothesized that Nrf2 may serve as a novel specific diagnostic biomarker. A single-center retrospective study, including 60 patients with PTC and 60 patients with nodular goiter, who underwent thyroidectomy at the Central Theater General Hospital from 2018 to July 2020, was conducted. The clinical data of the patients were collected. Nrf2, BRAF V600E, CK-19, and Gal-3 proteins were compared from paraffin samples of the patients. Through this study, we obtained the following results: i) Nrf2 exhibits high abundance expression in PTC, but not in adjacent to PTC and nodular goiter; increased Nrf2 expression could serve as a valuable biomarker for PTC diagnosis; the sensitivity and specificity for the diagnosis of PTC were 96.70% and 89.40%, respectively. ii) Nrf2 also shows higher expression in PTC with lymph node metastasis, but not adjacent to PTC and nodular goiter, thus the increased Nrf2 expression might serve as a valuable predictor for lymph node metastasis in PTC patients; the sensitivity and specificity for the prediction in lymph node metastasis were 96.00% and 88.57%, respectively; excellent diagnostic agreements were found between Nrf2 and other routine parameters including HO-1, NQO1 and BRAF V600E. iii) The downstream molecular expression of Nrf2 including HO-1 and NQO1 consistently increased. In conclusion, Nrf2 displays a high abundance expression in human PTC, which leads to the higher expression of downstream transcriptional proteins: HO-1 and NQO1. Moreover, Nrf2 can be used as an extra biomarker for differential diagnosis of PTC and a predictive biomarker for lymph node metastasis of PTC.
甲状腺乳头状癌 (PTC) 是最常见的甲状腺恶性肿瘤。然而,将 PTC 与良性癌区分开来非常困难。因此,人们积极寻求特定的诊断生物标志物。先前的研究观察到 Nrf2 在 PTC 中高度表达。基于这项研究,我们假设 Nrf2 可能成为一种新的特异性诊断生物标志物。一项单中心回顾性研究纳入了 2018 年至 2020 年 7 月在中部战区总医院接受甲状腺切除术的 60 例 PTC 患者和 60 例结节性甲状腺肿患者,收集了患者的临床资料。比较了患者石蜡样本中的 Nrf2、BRAF V600E、CK-19 和 Gal-3 蛋白。通过这项研究,我们得到了以下结果:i)Nrf2 在 PTC 中呈高丰度表达,但在 PTC 旁和结节性甲状腺肿中不表达;增加的 Nrf2 表达可以作为 PTC 诊断的有价值的生物标志物;诊断 PTC 的敏感性和特异性分别为 96.70%和 89.40%。ii)Nrf2 在有淋巴结转移的 PTC 中也表现出更高的表达,但在 PTC 旁和结节性甲状腺肿中不表达,因此增加的 Nrf2 表达可能是 PTC 患者淋巴结转移的有价值的预测因子;预测淋巴结转移的敏感性和特异性分别为 96.00%和 88.57%;在 Nrf2 与 HO-1、NQO1 和 BRAF V600E 等常规参数之间发现了极好的诊断一致性。iii)Nrf2 的下游分子表达包括 HO-1 和 NQO1 一致增加。总之,Nrf2 在人 PTC 中呈高丰度表达,导致下游转录蛋白 HO-1 和 NQO1 的表达增加。此外,Nrf2 可作为 PTC 鉴别诊断的附加生物标志物和 PTC 淋巴结转移的预测生物标志物。