CK19、CD56和p53在甲状腺微小乳头状癌和乳头状增生中的表达差异及意义  

Difference expression of CK19, CD56, p53 and its significance in PMC and papillary hyperplasia

作　　者：陈亮 秦伟 张凯 

机构地区：[1]抚顺市中心医院普外科,辽宁抚顺113006

出　　处：《中国现代普通外科进展》2017年第8期635-638,659,共5页Chinese Journal of Current Advances in General Surgery

摘　　要：目的 :探讨CK19、CD56和p53在甲状腺微小乳头状癌(PM C)和甲状腺乳头状增生(PTH)中的表达差异及其意义。方法:选取手术切除的PMC组织75例、PTH组织37例,比较PMC和PTH组织中CK19、CD56和p53表达的差异。分析PM C组织中CD56和p53的表达与病理参数的关系。分析CK19、CD56和p53鉴别诊断PM C和PTH的效能。结果 :PM C组织中的CK19和p53表达阳性率(100%和65.33%)高于PTH组织(32.43%和13.51%),PMC组织中的CD56表达阳性率(6.67%)低于PTH组织(62.16%),且差异均有统计学意义(P<0.05)。PM C组织中的CD56表达阳性率在性别、年龄、病灶大小、淋巴结转移、TNM分期以及分化程度中的差异均无统计学意义(P>0.05)。TNM分期Ⅲ+Ⅳ期患者的p53表达阳性率高于Ⅰ+Ⅱ期患者(79.31%比26.52%,P<0.05),高、中、低分化程度p53表达阳性率分别为46.43%、72.73%、85.71%,不同分化程度患者的p53表达阳性率差异有统计学意义(P<0.05)。CK19、CD56和p53鉴别诊断PM C和PTH的敏感度分别为100%、93.33%、65.33%,特异度分别为67.57%、62.16%、86.49%、准确度分别为89.29%、83.04%、72.32%;其中CK19敏感度最高,p53特异度最高,CK19准确度最高。结论:CK19和p53在PMC组织呈高表达,在PTH组织中也可呈阳性表达;CD56在PM C多呈阴性表达,可作为CK19和p53鉴别诊断PM C和PTH的辅助指标。Objective： To investigate the difference expression of CK19, CD56,p53 and its sig-nificance in PMC and papillary hyperptasia. Methods： 112 cases of papillary thyroid microcarcinoma and papillary thyroid hyperplasia were selected as the experimental materials from 2013 to 2015 years, compare the expression of CK19, CD56 and p53 in the tissues of PMC and PTC; To analyze the relationship between the expression of CD56 and p53 in PMC tissue and pathological parameters. The efficacy analyzed of CK19, CD56 and p53 in the differential diagnosis of PMC and PTH. Results- Expression positive rate of CK19 and p53 in PMC（100% and 65.33%） was higher than that of PTH （32.43% and 13.51%）, CD56 expression positive rate in PMC （6.67%） was lower than that of PTH （62.16%）, and the difference was statistically significant （P〈O：05）. The positive rate of CK19 expression in PMC was not statistically significant difference in gender, age, lesion size, lymph node metastasis, TNM stage and differentiation degree（P〉0.05）. TNM stage Ⅲ＋Ⅳ patients with p53 positive expression rate（79.31%） was higher than that of stage Ⅰ＋Ⅱ patients（26.52%）（P〈0.05）, the positive rates of p53 expression in the high, middle and low differentiation degree respectively were 46.43%, 72.73%, 85.71%, and the positive rate of p53 expression in patients with different degree of differentiation was statistically significant （P〈0.05）. The sensitivity of CK19, CD56 and p53 in the differential diagnosis of PMC and PTH were 100%, 93.33%, 65.33%, The specificity respectively was 67.57%, 62.16%, 86.49%, and the accuracy respectively was 89.29%, 83.04%, 72.32%; The sensitivity of CK19 was the highest, and the specificity of p53 was the highest, and the accuracy of CK19 was highest. Conclusions： The high expression of CK19 and p53 in PMC tissue, but also positive expression in PTH tissues, CD56 showed negative expression in PMC, which can be used as auxiliary indexes of CK19 and 1353 in the differential diagnosi

关 键 词：甲状腺微小乳头状癌 甲状腺乳头状增生 CKL9 CD56 P53 

分 类 号：R736.1[医药卫生—肿瘤]