广西医学

目的分析SET结构域分叉组蛋白赖氨酸甲基转移酶2（SETDB2）、半乳糖凝集素3（Gal-3）、pleckstrin同源结构域S1（PLEKHS1）在甲状腺乳头状癌组织中的表达情况，以及三者对患者预后的预测价值。方法（1）选择118例甲状腺乳头状癌患者作为研究组，45例甲状腺良性结节患者作为对照组。采用免疫组化法检测甲状腺乳头状癌组织和甲状腺良性结节组织中SETDB2、Gal-3、PLEKHS1蛋白表达情况。比较研究组与对照组之间，以及不同特征甲状腺乳头状癌患者之间病灶组织中SETDB2、Gal-3、PLEKHS1蛋白的阳性表达率。（2）随访1年，记录甲状腺乳头状癌患者的生存情况。分析SETDB2、Gal-3、PLEKHS1蛋白阳性表达和阴性表达患者的生存率；比较预后良好和预后不良患者SETDB2、Gal-3、PLEKHS1蛋白的阳性表达率。采用受试者工作特征（ROC）曲线分析SETDB2、Gal-3、PLEKHS1对甲状腺乳头状癌患者预后的预测价值。结果（1）与对照组相比，研究组病灶组织中SETDB2蛋白阳性表达率较低，Gal-3、PLEKHS1蛋白阳性表达率较高（P＜0.05）。在甲状腺乳头状癌患者中，Ⅲ～Ⅳ期、浸润深度≥1/2、组织中低分化、淋巴结转移、肿瘤直径＞1 cm的患者病灶组织中SETDB2蛋白阳性表达率更低，Gal-3、PLEKHS1蛋白阳性表达率更高（P＜0.05）。（2）在甲状腺乳头状癌患者中，SETDB2蛋白阳性表达患者生存率高于SETDB2蛋白阴性表达患者，Gal-3、PLEKHS1蛋白阳性表达患者生存率低于Gal-3、PLEKHS1蛋白阴性表达患者（P＜0.05）；预后良好患者的SETDB2蛋白阳性表达率高于预后不良患者，Gal-3、PLEKHS1蛋白阳性表达率低于预后不良患者（P＜0.05）。ROC曲线分析结果显示，SETDB2、Gal-3、PLEKHS1蛋白总评分预测甲状腺乳头状癌患者预后不良的曲线下面积分别为0.826、0.841、0.859。结论在甲状腺乳头状癌中，SETDB2呈低表达，而Gal-3、PLEKHS1呈高表达，三者均与患者的病情严重程度相关，且对预后具有一定的预测价值。

ObjectiveTo analyze the expressions of SET domain bifurcated histone lysine methyltransferase 2 (SETDB2), galectin-3 (Gal-3), pleckstrin homology domain containing S1 (PLEKHS1) in tissues of papillary carcinoma of thyroid, and predictive value of the three on patients′ prognosis. Methods(1) A total of 118 patients with papillary carcinoma of thyroid were selected as study group, and 45 patients with thyroid benign nodules were selected as control group. The protein expressions of SETDB2, Gal-3, and PLEKHS1 were detected in tissues of papillary carcinoma of thyroid and thyroid benign nodules by employing the immunohistochemistry. The positive expression rates of SETDB2, Gal-3, and PLEKHS1 proteins in lesion tissues were compared between the study group and the control group, and between patients with papillary carcinoma of thyroid in different characteristics. (2) The survival status was recorded in patients with papillary carcinoma of thyroid within 1 year of follow-up. The survival rates of patients with positive and negative expressions of SETDB2, Gal-3, and PLEKHS1 proteins were analyzed. The positive expression rates of SETDB2, Gal-3, and PLEKHS1 proteins were compared between patients with favorable prognosis and adverse prognosis. The predictive value of SETDB2, Gal-3, and PLEKHS1 on prognosis in patients with papillary carcinoma of thyroid was analyzed by using the receiver operating characteristic (ROC) curve.Results(1) Compared with the control group, the positive expression rate of SETDB2 protein in lesion tissues of the study group was lower, and the positive expression rates of Gal-3 and PLEKHS1 proteins in lesion tissues of the study group were higher (P＜0.05). In patients with papillary carcinoma of thyroid, patients in stage Ⅲ-Ⅳ, and with invasion depth≥1/2, medium-low differentiation of tissues, lymph node metastasis, tumor diameter＞1 cm obtained a lower positive expression rate of SETDB2 protein in lesion tissues, and higher positive expression rates of Gal-3 and PLEKHS1 proteins in lesion tissues (P＜0.05). (2) In patients with papillary carcinoma of thyroid, the survival rate of patients with positive expression of SETDB2 protein was higher than that of patients with negative expression of SETDB2 protein, and the survival rates of patients with positive expressions of Gal-3 and PLEHS1 proteins were lower than those of patients with negative expressions of Gal-3 and PLEHS1 proteins(P＜0.05); furthermore, the positive expression rate of SETDB2 protein in patients with favorable prognosis was higher than that in patients with adverse prognosis, and the positive expression rates of Gal-3 and PLEKHS1 proteins were lower than those in patients with adverse prognosis (P＜0.05). The results of ROC curve analysis revealed that areas under the curve of the total scores of SETDB2, Gal-3, and PLEKHS1 proteins for predicting adverse prognosis of patients with papillary carcinoma of thyroid were 0.826, 0.841, and 0.859, respectively. ConclusionIn patients with papillary carcinoma of thyroid, SETDB2 presents as low expression, while Gal-3 and PLEKHS1 as high expressions, and all of the three are related to patients′ severity, exerting predictive value on prognosis to a certain extent.