甲状腺乳头状癌伴神经内分泌分化的免疫组化、超微结构及免疫金标记研究  

Immunohistochemical,ultrastructural analysis and immunogold labelling of papillary thyroid carcinoma with neuroendocrine differentiation

作　　者：张婷[1] 何松[2] 陈旭东[2] 陆晓云[2] 杨书云[2] 周建云[2] 张建兵[3] 潘红佳 严桥[5] 

机构地区：[1]湖州师范学院医学院病理教研室,浙江湖州313000 [2]南通大学附属肿瘤医院病理科,江苏南通226361 [3]浙江大学医学院附属邵逸夫医院病理科,浙江杭州310016 [4]嘉兴市第二医院病理科,浙江嘉兴314000 [5]南通大学医学院病理教研室.江苏南通226001

出　　处：《南京医科大学学报（自然科学版）》2013年第11期1529-1536,共8页Journal of Nanjing Medical University(Natural Sciences)

基　　金：南通市社会发展科技计划(S5010)

摘　　要：目的:探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的神经内分泌(NE)分化与临床病理形态学特征及预后因素的关系。方法:手术切除PTC 103例,行HE染色后光镜下观察、免疫组织化学染色后光镜及透射电镜检查、免疫金标记后电镜观察PTC临床病理形态学、光镜及电镜下NE标记(NSE、CgA、Syn)表达及电镜CgA标记的致密核心颗粒表达;分析上述NE标记表达与临床病理参数及预后因素的关系。结果 :PTC表达NSE 64例(62.14%),与肿瘤直径呈正相关(P<0.05);表达CgA25例(24.27%),与肿瘤分化程度呈负相关,与核内包涵体呈正相关(P<0.05);Syn均呈阴性;NSE及CgA共同表达23例(22.33%)。透射电镜PTC致密颗粒检出率为18.2%(12/66);PTC细胞分化程度、肿瘤直径与NE分化有关(P<0.05);免疫金标记电镜观察CgA免疫金颗粒3例(2.91%)。CgA定位于PTC癌细胞胞浆内的NE颗粒边缘呈散在分布。结论:PTC中NE分化细胞可能来源于滤泡上皮细胞;NE分化与PTC瘤体直径、细胞核形态改变及癌细胞分化程度有关,与预后无关。Objective：To investigate the correlation between neuroendocrine（NE）differentiation and clinico-pathological features,prognostic factors of papillary thyroid carcinoma（PTC）. Methods：The tissues of 103 PTC cases were amaylzed by HE staining,immunohisto-chemistry,immunogold labelling,biomarkers expression of neuroendocrine differentiation. Results：Thyroglobulin was positively expressed in PTC,while Calcitonin was negative. The larger tumor size of the cases with PTC accompanied with a higher NSE expression（P 〈 0.05）. The higher degree of differentiation accompanied with a lower rate of CgA expression. The cases with nuclear inclusions showed obviously increased expression of CgA（P 〈 0.05）. The degree of PTC cell differentiation and tumor size were associated with NE differentiation under TEM（P 〈 0.05）. The CgA immunogold particles were scattered at the internal edge of NE particles within the cytoplasm of PTC cells. Conclusion：NE differentiation could occur in PTC,and NE differentiated cells could be derived from follicular epithelial cells instead of C cells. NE differentiation is correlated with tumor size,morphological change of nuclei and degree of differentiation in PTC. NE differentiation has no significant correlation with the prognosis of PTC.

关 键 词：甲状腺乳头状癌 神经内分泌分化 免疫组织化学 透射电镜 免疫金标 

分 类 号：R736.1[医药卫生—肿瘤]