甲状腺良恶性病变中HCK、HBME-1及TPO的表达及临床价值  

Expression of HCK, HBME-1 and TPO in thyroid neoplasm and their clinical significance

作　　者：周荣璟 丁金旺 赵海菲[1] 徐益平[1] 徐骁诚 吴龙凤 陈凯 罗定存 

机构地区：[1]杭州市肿瘤医院病理科,杭州310002 [2]杭州市第一人民医院(南京医科大学附属杭州医院)肿瘤外科 [3]江苏省苏州市吴江区第一人民医院甲乳外科 [4]杭州市肿瘤医院肿瘤外科,杭州310002

出　　处：《浙江医学》2017年第22期1972-1975,共4页Zhejiang Medical Journal

基　　金：浙江省公益技术应用研究项目(2017C33180);杭州市重大科技创新专项项目(20131813A08);杭州市科技计划项目(20160533B05)

摘　　要：目的探讨高分子量角蛋白(HCK)、人骨髓内皮细胞标记物(HBME-1)及甲状腺过氧化物酶(TPO)3个蛋白标记物在甲状腺良恶性病变中的表达差异,评价其在观察组甲状腺乳头状癌(PTC)与对照组甲状腺良性病变中的临床诊断价值。方法采用免疫组化方法检测并比较268例PTC与134例甲状腺良性病变组织中HCK、HBME-1及TPO的表达,分析3个蛋白标记物与PTC临床病理特征的相关性,并计算上述指标对PTC的诊断效能。结果观察组中HCK、HBME-1的阳性表达率分别为96.64%(259/268)、95.15%(255/268),TPO的阴性表达率为88.48%(237/268),与对照组比较差异均有统计学意义(P<0.01)。不同性别、年龄、病灶数目、肿瘤大小、被膜是否突破、淋巴结转移状况、TNM分期及复发危险度PTC患者HCK、HBME-1、TPO表达的差异均无统计学意义(均P>0.05)。HCK、HBME-1及TPO诊断PTC的灵敏度分别为96.64%(259/268)、95.15%(255/268)、88.48%(237/268),特异度分别为91.79%(123/134)、84.33%(113/134)、95.52%(128/134),准确度分别为95.02%(382/402)、91.54%(368/402)、90.79%(365/402)。结论 HCK、HBME-1及TPO在甲状腺良恶性病变中的表达差异有统计学意义,其对鉴别甲状腺结节的良恶性质具有重要的临床价值。Objective To investigate the expressions of high molecular weight cytokeratin（HCK）, human bone marrow endothelial cell-1（HBME-1） and thyroid peroxidase（TPO） in thyroid neoplasm, and their clinical significance. Methods En Vision TM immunohistochemical technique was performed to detect the expression of HCK, HBME-1 and TPO in 268 samples of papillary thyroid carcinoma（PTC） and 134 samples benign thyroid nodules. The correlation between expressions of the three markers and clinicpathological characteristics was evaluated. Results The positive rate of HCK, HBME-1 and TPO in PTC was significantly higher than those in benign nodules（all P0.01）. There was no association between the expression of the three protein markers and clinicpathological characteristics of patients, including sex, age, numbers of lesions, tumor size, capsular invasion,lymph node metastasis, TNM staging and recurrence relative risk. The sensitivity of HCK, HBME-1 and TPO for diagnosis of PTC was 96.64%, 95.15% and 88.48%, and the specificity was 91.79%, 84.33% and 95.52% with a diagnostic accuracy rate of 95.02%,91.54% and 90.79%, respectively. Conclusion The expressions of HCK, HBME-1 and TPO in PTC are higher than those in benign lesions, indicating that these protein markers may have diagnostic value for PTC.

关 键 词：甲状腺肿瘤 高分子量角蛋白 人骨髓内皮细胞标记物 甲状腺过氧化物酶 

分 类 号：R736.1[医药卫生—肿瘤]