IgG4在桥本甲状腺炎中的表达及临床病理特征  

The expression of IgG4 in thyroid tissues of hashimoto's thyroiditis and their clinicopathological characters

作　　者：王晓琳[1] 王昭顺[2] 董玮[1] 郭璐[3] 曲美婷 

机构地区：[1]潍坊市中医院,山东潍坊261041 [2]潍坊市人民医院,山东潍坊261041 [3]潍坊医学院附属医院,山东潍坊261041

出　　处：《中国卫生检验杂志》2015年第19期3297-3299,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的探讨Ig G4在桥本甲状腺炎中的表达及其相关的临床病理特征,为Ig G4 HT的诊断、鉴别诊断与治疗提供依据。方法通过对桥本甲状腺炎、亚急性甲状腺炎、结节性甲状腺肿等疾病的甲状腺组织进行HE和免疫组化染色,结合B超、临床资料等分析Ig G4 HT的临床病理特征。结果 41例HT中,CD3、CD20、CD38、CD138、Ig G均为阳性,Ig G4 HT有13例(31.71%),其中Ig G、Ig G4阳性明显高于非Ig G4 HT组,差异具有统计学意义(P<0.05);结合临床、B超检查及HE染色显示Ig G4 HT的平均发病年龄为(49.2±9.32)岁,常表现为弥散低回声或混合回声结节,且间质纤维化程度更加明显,差异均具有统计学意义(P<0.05)。结论 HT存在免疫功能异常,其中Ig G4 HT亚型并不少见,自身抗原的持续暴露可以使Ig G4滴度升高并诱导纤维化的发生,这类患者具有特殊的临床病理特征,组织病理学及Ig G4免疫组织化学检查有助于Ig G4 HT患者的及时诊断和治疗。Objective To investigate the clinicopathological characters of Ig G4 HT in thyroid tissues,so as to provide basis for the diagnosis,differential diagnosis and treatment. Methods HE and immunohistochemistry dyeing were carried out on the thyroid tissues for subacute thyroiditis,thyroid carcinoma and thyroid adenoma. Clinical and pathological characteristics of HT Ig G4 were analyzed by combining with B ultrasound and clinical data. Results In all 41 HT cases,CD3,CD20,CD38 and CD138 were all positive,13 of them（ 31. 71%） were diagnosed as Ig G4 HT,the positive rate of Ig G and Ig G4 of Ig G4 HT was higher than that of non Ig G4 HT,and the difference had statistical significance（ P〈0. 05）. Combined with clinical,ultrasound examination and HE staining,it showed that the average happening age of HT Ig G4 was 49. 2 ± 9. 32 years old,and the expression were with low echo or mixed echo,and the degree of interstitial fibrosis was more obvious,the differences above were statistically significant（ P〈0. 05）. Conclusion Ig G4 HT is not uncommon in the presence of immune function abnormalities. Continuous exposure of the self antigen can increase the Ig G4 titer and induce the occurrence of fibrosis,so this type of patient has special clinical and pathological characteristics,tissue pathology and Ig G4 immunohistochemical examination are helpful for the diagnosis and treatment of HT Ig G4 patients.

关 键 词：桥本甲状腺炎 IG G4 免疫组织化学 

分 类 号：R581.4[医药卫生—内分泌]