四项免疫组化标志物在诊断甲状腺乳头状癌中的临床意义  

Clinical significance of four immunohistochemical markers in the diagnosis of the papillary thyroid carcinoma

作　　者：李天一[1] 吴钢[1] 蔡端[1] 

机构地区：[1]复旦大学附属华山医院,上海200040

出　　处：《上海医药》2014年第10期24-27,共4页Shanghai Medical & Pharmaceutical Journal

基　　金：宝山区科学技术委员会基金资助项目(11-E-13)

摘　　要：目的 :探讨Ki67核抗原(Ki67),甲状腺转录因子-1(TTF-1),人表皮生长因子受体-2(HER-2/neu)和人骨髓内皮细胞-1(HBME-1)对于鉴别诊断甲状腺乳头状癌(papillary thyroid carcinoma,PTC)和甲状腺良性结节的临床意义。方法 :回顾分析180例PTC和190例甲状腺良性结节的石蜡切片,采用免疫组化法检测Ki67,TTF-1,HBME-1和HER-2/neu水平。结果 :4种标志物在PTC中表达的阳性率明显高于甲状腺良性结节(P=0.000)。采用单一标志物检测时,HER-2/neu的敏感性最高(79.4%),TTF-1的特异性最高(96.8%)。Ki67+HER-2/neu+HBME-1 3者联合检测的敏感性最高(89.8%),HER-2/neu+TTF-1和HER-2/neu+TTF-1+HBME-1联合检测具有相同的特异性(99.4%,P<0.01)。结论:在PTC中,Ki67和TTF-1在联合HER-2/neu或(和)HBME-1检测时,可显著提高单项指标检测PTC的敏感性和特异性。Objective：To investigate the clinical value of differentiation of the papillary thyroid carcinoma （PTC） from the benign thyroid nodules with Ki67 nuclear antigen （Ki67）, thyroid transcription factor-l （TTF-1）, human epidermal growth factor receptor type-2 （HER-2/neu）, and human bone marrow endothelial cell-1（HBME-1）. Methods：The paraifn sections of 180 cases with PTC and 190 cases with the benign thyroid nodules were retrospectively analyzed. The levels of Ki67, TTF-1, HBME-1 and HER-2/neu were determined immunohistochemically. Results：The positive rates of the expressions of 4 markers were higher in PTC specimens than in the benign thyroid nodules specimens （P=0.000）. When using a single marker, the detection of HER-2/neu had the most sensitivity （79.4%） and that of HBME-1 the most speciifcity （96.8%）. The detection combined with Ki67, HER-2/neu and HBME-1 had the most sensitivity （89.8%）. The detection combined with HER-2/neu＋TTF-1 and HER-2/neu＋TTF-1＋HBME-1 had the same speciifcity （99.4%, P〈0.01）. Conclusions：When combining Ki67 and TTF-1 with HER-2/neu or HBME-1, the sensitivity and speciifcity in the single indicator determination can be increased obviously in the diagnosis of PTC.

关 键 词：甲状腺乳头状癌 Ki67核抗原 甲状腺转录因子-1 人表皮生长因子受体-2 人骨髓上皮细胞-1 

分 类 号：R736.1[医药卫生—肿瘤]