TPO、HBME-1、CK19、Galectin-3、CyclinD1检测在甲状腺良恶性病变中的鉴别诊断价值  

Differential diagnosis value of TPO, HBME-1, CK19, Galectin-3, CyclinD1 in benign and malignant thyroid lesions

作　　者：周艳 罗枫 伍世钢 阮君 ZHOU Yan;LUO Feng;WU Shi-gang;RUAN Jun(Department of Pathology,the Sixth Affiliated Hospital of Guangzhou Medical University,Qingyuan People’s Hospital,Qingyuan 511518,Guangdong,CHINA)

机构地区：[1]广州医科大学附属第六医院(清远市人民医院)病理科

出　　处：《海南医学》2020年第1期27-30,共4页Hainan Medical Journal

基　　金：广东省清远市科技计划项目(编号：2016B047)

摘　　要：目的探讨甲状腺过氧化物酶(TPO)、间皮细胞(HBME-1)、细胞角蛋白19(CK19)、半乳糖凝素-3(Galectin-3)、细胞周期蛋白D1(CyclinD1)检测在甲状腺乳头状癌(PTC)与甲状腺良性病变(BTL)中的鉴别诊断价值。方法收集2012-2018年间清远市人民医院PTC患者269例及BTL患者264例,采用免疫组织化学EnVision两步法检测两组患者TPO、HBME-1、CK19、Galectin-3、CyclinD1的表达水平,比较其阳性表达率、灵敏度、特异性;比较有无淋巴转移组患者的CyclinD1阳性率。结果PTC组患者TPO、HBME-1、CK19、Galectin-3、CyclinD1的阳性表达率分别为16.0%(43/269)、86.6%(233/269)、100.00%(269/269)、98.6%(206/209)、89.3%(183/205),而B TL组患者的阳性表达率分别为93.9%(248/264)、13.4%(34/253)、44.3%(117/264)、26.2%(53/202)、28.9%(58/201),两组患者以上五个指标的阳性表达率比较差异均有统计学意义(P<0.05);TPO、HBME-1、CK19、Galectin-3、CyclinD1用于PTC诊断时的灵敏度分别为84.01%、86.62%、100.00%、98.56%、89.26%,特异性分别为93.94%、86.56%、55.56%、73.76%、71.14%;CyclinD1在淋巴结转移组的阳性率为92.7%(51/55),在无淋巴结转移组的阳性率为88.0%(132/150),两者间阳性率比较差异无统计学意义(P>0.05)。结论TPO、HBME-1、CK19、Galectin-3、CyclinD1的检测可应用于PTC与良性病变的鉴别诊断;CyclinD1表达对甲状腺乳头状癌的淋巴结转移无提示作用。Objective o investigate the differential diagnosis value of thyroid peroxidase(TPO),hector battifora mesothelial cell(HBME-1),cytokeratin-19(CK-19),galectin-3 and cyclin D1 in papillary thyroid carcinoma(PTC)and benign thyroid lesion(BTL).Methods A total of 269 cases of PTC and 264 cases of benign thyroid lesions treated in Qingyuan People’s Hospital from 2012 to 2018 were enrolled.The expression leves of TPO,HBME-1,CK19,Galectin-3,cyclin D1 proteins in the two groups were detected by EnVision two-step method.The positive rate,sensitivity and specificity were compared,and the positive rate of cyclin D1 in the group with or without lymphatic metastasis were compared.Results The positive rates of TPO,HBME-1,CK19,galectin-3,cyclin D1 expression in the PTC group were 16.0%(43/269),86.6%(233/269),100.0%(269/269),98.6%(206/209),89.3%(183/205),respectively,as compared with corresponding 93.9%(248/264),13.4%(34/253),44.3%(117/264),26.2%(53/202),28.9%(58/201)in benign thyroid lesions(all P<0.05).The diagnosis sensitivity of TPO,HBME-1,CK19,galectin-3,cyclin D1 for PTC were 84.01%,86.62%,100.00%,98.56%,89.26%,respectively,and the specificity were 93.94%,86.56%,55.56%,73.76%,71.14%,respectively.The positive rate of cyclin Dl expression in the lymph node metastasis group was 92.7%(51/55)versus 88.0%(132/150)in the no-metastasis group(P>0.05).Conclusion The detection of TPO,HBME-1,CK19,Galectin-3,cyclin D1 markers can contribute to differential diagnosis between PTC and benign thyroid lesions,significantly improving the accuracy of the pathological diagnosis and providing a reliable basis for clinical treatment.The expression of cyclin Dl has no suggestive effect on lymph node metastasis of PTC.

关 键 词：甲状腺乳头状癌 甲状腺过氧化物酶 间皮细胞 细胞角蛋19 半乳糖凝素-3 细胞周期蛋白D1 免疫组化 甲状腺良性病变 

分 类 号：R581[医药卫生—内分泌]