甲状腺乳头状癌诊断与鉴别的可靠标记物  

Reliable markers for differential diagnosis of papillary thyroid carcinoma

作　　者：何春年[1] Lili H Jin Q CH 陈士超[1] 赵焕芬[1] 翟金萍[1] 

机构地区：[1]河北省人民医院病理科,石家庄050051 [2]Department of Pathology, H Lee Moflitt Cancer Center andResearch Institute, University of South Florida College ofMedieine, Tampa 33612, USA

出　　处：《临床与实验病理学杂志》2007年第6期694-698,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：河北省卫生厅医学科学研究重点项目(06007)

摘　　要：目的寻找更好的标记物,用于甲状腺乳头状癌的诊断与鉴别。方法以甲状腺乳头状癌(PTC)为研究组,以甲状腺滤泡状腺瘤(FA)和良性乳头状病变(BPL)作对照组。经自制组织芯片和免疫组化技术,对Twist、Galectin-3、HBME-1、p14ARF和TPO进行标记,并与CK19对比实验。结果6种指标阳性表达率依次为:PTC组100.0%、95.6%、80.0%、28.9%、15.6%和78.0%;FA组0.0、11.1%、6.7%、75.6%、88.9%和0.0;BPL组7.0%、7.5%、2.5%、77.5%、100.0%和0.0。PTC组与FA和BPL组比较差异均有显著性(P<0.05)。6种指标的灵敏度、特异度、准确度分别为100.0%、95.6%、80.0%、71.1%、84.4%、78.0;96.4%、90.1%、95.3%、76.5%、94.1%、100.0%和97.7%、92.3%、90.0%、74.6%、90.8%、91.9%。结论在PTC中6种指标阳性表达率最高的为Twist,其次为Galectin-3,因此临床病理工作中标记Twist和Galectin-3鉴别PTC与FA或BPL有实用意义。Twist的灵敏度和准确度最高,CK19特异度最高。因此该2种指标联合使用对于PTC的鉴别诊断最可靠。Purpose To search for much better markers in the differential diagnosis of papillary thyroid carcinoma （PTC）. Methods PTC were designated as study group, and follicular adenomas （FA） and benign papillary lesions （BPL） were control group. Manual tissue chip and SP immunohistochemical stain were performed to detect the expression of Twist, Galectin-3, HBME-1, p14^ARF, TPO and CK19 （control marker） in PTC, FA and BPL. Results In PTC, positive rates of Twist, Galectin-3, HBME-1, p14^ARF, TPO and CK19 were 100.0%, 95.6%, 80.0%, 28.9%, 15.6% and 78.0% ;in FA, positive rates were 0.0, 11.1%, 6.7%, 75.6%, 88. 9% and 0. 0;in BPL, positive rates were 7. 0%, 7.5%, 2. 5%, 77. 5%, 100. 0% and 0.0,respectively. The differences between PTC and FA and between PTC and BPL were both statistically significant（ P 〈 0. 05 ）. The sensitivity of Twist, Galectin-3, HBME-1, p14^ARF , TPO and CK19 was 100. 0%, 95.6%, 80. 0%, 71.1%, 84.4%, 78. 0% ; the specificity was 96. 4%, 90. 1%, 95.3%, 76. 5%, 94. 1%, 100. 0% ; Overall accuracy was 97.7%, 92. 3%, 90.0%, 74. 6% , 90. 8%, and 91.9% , respectively. Conclusions In PTC, the highest positive rate is Twist, followed by Galectin-3. So, Twist and Galectin-3 may be useful in differentiating PTC from FA and BPL. Twist has the highest sensitivity and overall accuracy. The specificity of CK19 was the highest. Therefore, a two-marker antibody panel with Twist and CK19 was the most efficient for the differential diagnosis of PTC.

关 键 词：甲状腺肿瘤 乳头状癌 Twsit GALECTIN-3 HBME-1 P14^ARF TPO CK19 组织芯片 

分 类 号：R736.1[医药卫生—肿瘤]