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| Clinicopathological Significance of SMAD3 and CD44 Expression in Papillary Thyroid Carcinoma and Its Influence on Prognosis |
| LV Dong, TANG Liangcheng, SUN Qing |
| Chuzhou First People's Hospital Affiliated to Anhui Medical University, Anhui Chuzhou 239000, China |
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Abstract Objective: To investigate the clinicopathological significance of the expression of signal transduction molecule 3 (SMAD3) and leukocyte differentiation antigen 44 (CD44) in papillary thyroid carcinoma and its influence on prognosis. Methods: The study subjects were 110 patients with papillary thyroid carcinoma received surgical treatment from August 2020 to October 2023. mRNA and protein expression level differences in SMAD3 and CD44 in papillary thyroid carcinoma tissues and peripheral paracancerous tissues were analyzed using real-time quantitative PCR method and immunohistochemistry. According to the presence or absence of cervical lymph node metastasis, the patients were grouped into metastatic group (n=56) and non-metastatic group (n=54). The clinical data and relevant laboratory indicators between the two groups were compared, and the expression levels of SMAD3 and CD44 proteins in lesion tissues were recorded. Univariate and multivariate Logistic analysis was used to analyze the correlation between each index and cervical lymph node metastasis. Results: SMAD3mRNA and CD44mRNA levels were higher in papillary thyroid carcinoma tissues than in paraneoplastic tissues, and the positive expression rate of SMAD3 protein and CD44 protein was higher than that in paraneoplastic tissues (P< 0.05). The mRNA level and protein level of SMAD3 in patients in the metastasis group were higher than those in the non-metastasis group (P<0.05); SMAD3 positive expression was found in 51 cases of 110 patients, accounting for 46.36% of the total; the difference in the positive expression rate of SMAD3 protein in the clinicopathological characteristics of patients with different genders, ages, tumor diameters, and foci conditions was not statistically significant (P＞0.05); the positive expression rate of SMAD3 protein in patients with lymph node metastasis was higher than that in those without lymph node metastasis (P＜0.05); 60 cases of 110 patients had positive expression of CD44 protein, accounting for 54.55% of the total; the difference in the positive expression rate of CD44 protein in the clinicopathological characteristics of patients with different genders, ages, tumor diameters, and foci conditions was not statistically significant (P＞0.05), and the difference in the positive expression rate of CD44 protein in patients with lymph node metastasis was higher than that of those without lymph node metastasis (P<0.05). The levels of NLR, PDW, uric acid, urea nitrogen and creatinine in patients with lymph node metastasis were higher than those in the group without metastasis (P<0.05); the differences in the composition of gender, age, tumor diameter and lesion condition between the two groups were not statistically significant (P>0.05); the results of multifactorial Logistic analysis showed that SMAD3 positive expression, CD44 positive expression and elevated levels of various laboratory indices were the independent risk factors of cervical lymph node metastasis (P<0.05). Conclusion: SMAD3 and CD44 in patients with papillary thyroid cancer showed abnormal expression in cancer tissues, which can be used as an index to improve the early diagnosis rate and provide a reference for the evaluation of lymph node metastasis.
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2025, Vol. 31 
