IgG4乔本甲状腺炎中TRAIL、FasL的表达及临床病理意义  

Clinicopathological significance of Serum concentrations of TRAIL and FasL in patients with IgG4 Hashimoto's thyroiditis

作　　者：曹慧秋[1] 吴海燕[1] 廖银花[1] 陈灿斌[1] 龚小勇[1] 

机构地区：[1]湖南郴州市第一人民医院病理科,湖南郴州423000

出　　处：《蛇志》2017年第1期1-3,共3页Journal of Snake

摘　　要：目的探究IgG4乔本甲状腺炎(IgG4Hashimoto's thyroiditis,IgG4HT)的临床、病理、血清学特征,分析血清TRAIL和/或FasL浓度与IgG4HT的临床、病理特征的相关性。方法采用免疫组化检测46例HT组织中的IgG^+、IgG4^+浆细胞,化学发光法及酶联免疫吸附测定法分别检测患者术前血清TgAb,TPOAb和TRAIL、FasL的浓度,并进行分析。结果依据IgG4+浆细胞>20/HPF、IgG4^+/IgG^+浆细胞>30%的诊断标准,HT组中11例(23.9%)为IgG4 HT。IgG4 HT较非IgG4HT具有更显著的甲状腺纤维化(P=0.006),更易发生亚临床甲状腺功能减退(P=0.02),血清TPOAb水平较低(P<0.001),FasL浓度较高(P<0.001);血清FasL浓度与IgG4HT甲状腺纤维化程度呈正相关(r=0.620,P=0.042),与甲状腺功能状态呈负相关(r=-0.841,P=0.001)。结论 IgG4HT为更具破坏性的乔本甲状腺炎亚型,FasL可能在甲状腺功能减退进程中发挥作用。Objective To explore whether IgG4 Hashimoto＇s thyroidi tis（HT） is a dist inct type of HT, wi th di f fer-ent clinical,pathological and serologic characteristics;To find out the clinicopathological significance of serum con-centrations of TRAIL and FasL in IgG4 relative HT. Methods Immunohis to chemistry was used to examine the expression of IgG and IgG4-positive plasma cells in 46 HT tissue samples. Serum concentrations of TPOAb,TgAb, TRAIL and Fas Ligand were measured by chemiluminescent immunoassay or ELISA. Statistical analysis was per-formed on the data. Results According to the cutoff value of〉20/HPF IgG4-posi t ive plasma cells and〉30% IgG4/IgG ratio,23. 9% of the HT pat ients were classified to IgG4 HT. Wi th contrast to non IgG4 HT group？the patient with IgG4 relative HT were related to a higher grade of stromal fibrosis （P = 0.006）,more subclinical hy - pothyroidism（P = 0. 02） ,a lower level of TPOAb （P〈C0. 001） and a higher concentration of FasL in serum（P〈0. 001）. Moreover,the serum concentration of FasL was not only inversely correlated with thyroid functional status （r =-0.841,P = 0. 001）,but also positively associated with the grade of stromal fibrosis in thyroid gland （r = 0.620 ,P=0.042）. Conclusion IgG4 HT represents a more dest ructive sub type. FasL may play a role in the pro-gress of subclinical hypothyroidism.

关 键 词：乔本甲状腺炎 IGG4相关性疾病 TRAIL FASL 

分 类 号：R581.4[医药卫生—内分泌]