CD147检测对细针穿刺细胞学可疑恶性的甲状腺结节的诊断价值  

Diagnostic value of CD147 detection for thyroid nodules suspicious for malignancy on fine-needle-aspiration cytology

作　　者：黄鹏[1] 常实[1] 江小林[1] 刘序[1] 袁正泰 张志鹏[1] 廖辉军[2] 董超[1] 

机构地区：[1]中南大学湘雅医院普通外科,湖南长沙410008 [2]湖南省郴州市第一人民医院肝胆外科,湖南郴州423000

出　　处：《中国普通外科杂志》2014年第5期591-595,共5页China Journal of General Surgery

基　　金：中南大学研究生自主探索创新基金资助项目(2013zzts318)

摘　　要：目的:探讨CD147检测在细针穿刺活检未能明确细胞学诊断的甲状腺结节中的临床应用价值。方法:选择2013年10月—12月收治的甲状腺结节患者,对术后手术标本进行细针穿刺涂片,用Bethesda甲状腺细胞学报告系统评价腺细胞病理学,选择36例"可疑恶性肿瘤"标本行免疫组化CD147染色分析。CD147阳性者作恶性诊断,结果与手术后石蜡病理结果比较。结果:CD147检测诊断良性病变19例(52.78%),恶性病变17例(47.22%),术后病理检查诊断良性病变16例(44.44%),恶性病变20例(55.56%);甲状腺恶性标本中CD147的阳性表达率明显高于良性标本(P<0.05)。CD147的表达与甲状腺结节是否钙化(CD147阳性率89.47%)及淋巴转移(CD147阳性率100%)有关(P<0.05)。细针穿刺细胞学联合CD147免疫组化染色鉴别甲状腺结节良、恶性的准确性和敏感度分别为91.67%和85.0%。结论:CD147可以作为甲状腺肿瘤细胞学诊断分子生物学标志物,细针穿刺细胞学联合CD147免疫组化分析,有助于提高甲状腺癌的术前检出率。Objective： To assess the clinical application value of CD147 detection in thyroid nodules with nondiagnositic cytologic results from fine-needle-aspiration （FNA） biopsy.Methods： Patients with thyroid nodules admitted from October to December 2013 were selected, and their postoperative surgical specimens were used for FNA smear test. According to thyroid cytopathology results using the Bethesda reporting system, immunohistochemical staining for CD147 was conducted in 36 samples suspicious for malignancy; the CD147 positive cases were considered as malignant, and the results were compared with the postoperative pathological diagnosis of the paraffin sections.Results： Nineteen cases （52.78%） were considered benign and 17 cases were considered malignant by CD147 staining, while 16 and 20 cases were proven benign and malignant respectively by postoperative pathological examination. CD147 positive expression rate in malignant lesions was significantly higher than that in benign lesions （P〈0.05）. CD147 expression was associated with calcification of the thyroid nodules （CD147 positive rate was 89.47%） and lymph node metastasis （CD147 positive rate was 100%）. The accuracy and sensitively of FNA plus CD147 immunochemical analysis for differential diagnosis of benign and malignant thyroid lesions was 91.67% and 85.0%, respectively.Conclusion： CD147 can be used as a molecular biological marker for thyroid cytopathologic diagnosis, and FNA biopsy combined with CD147 immunochemical analysis could improve the preoperative detection rate of thyroid cancer.

关 键 词：甲状腺肿瘤 诊断 活组织检查 细针 抗原 CD147 

分 类 号：R736.1[医药卫生—肿瘤]