US-FNAC结合CT、CgA和TG免疫组织化学染色在甲状腺髓样癌诊断中的应用  

The application of US-FNAC combined with immunohistochemical stainings of CT,CgA and TG in the diagnosis of medullary thyroid carcinoma

作　　者：雷清华[1,2] 王新方 王雄威[3] 洪练青[4] Lei Qinghua;Wang Xinfang;Wang Xiongwei;Hong Lianqing(Department of Human Anatomy,School of Basic Medical Sciences,Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;National Demonstration Center for Experimental Basic Medical Education,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China;Department of Ultrasound imaging,Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated with Nanjing University of Chinese Medicine,Nanjing 210014,China;Department of Pathology,Nanjing Integrated Traditional Chinese and Western Medicine Hospital Affiliated with Nanjing University of Chinese Medicine,Nanjing 210014,China)

机构地区：[1]华中科技大学同济医学院基础医学院解剖学系,武汉430030 [2]华中科技大学同济医学院基础医学国家级实验教学示范中心,武汉430030 [3]南京中医药大学附属南京市中西医结合医院超声影像科,南京210014 [4]南京中医药大学附属南京市中西医结合医院病理科,南京210014

出　　处：《中国组织化学与细胞化学杂志》2024年第1期50-55,共6页Chinese Journal of Histochemistry and Cytochemistry

基　　金：教育部产学合作协同育人项目(220601164153451)。

摘　　要：目的探讨超声引导下细针穿刺细胞学(ultrasound-guided fine-needle aspiration cytology,US-FNAC)联合降钙素(calcitonin,CT)、嗜铬素A(chromogranin A,Cg A)、甲状腺球蛋白(thyroglobulin,Tg)诊断甲状腺髓样癌(medullary thyroid cancer,MTC)的应用价值。方法对7例US-FNAC诊断且术后组织病理学确诊的MTC临床资料和超声特点、细胞病理学特征进行综合分析。细针穿刺标本采用常规涂片1~2张自然风干后刘氏染色液快速染色,现场进行细胞病理学评判,确保取得满意的细胞量,同时将剩余标本注入液基细胞保存液中保存,采用液基薄层制片,HE染色及CT、CgA和Tg免疫组织化学染色。结果7例MTC细胞均中等量到大量,均有散在突出的大细胞、双核细胞、浆样细胞或核偏位不规则细胞;6例伴梭形细胞,细胞病理学表现与MTC细胞学诊断标准基本相符,CT、CgA胞质均弥漫强阳性表达,Tg阴性,细胞病理学诊断为MTC。结论US-FNAC技术可提高甲状腺结节细针穿刺标本满意度,结合液基薄层制片与CT、CgA免疫组织化学染色可提高MTC术前诊断准确性,对MTC治疗具有重大的临床意义。Objective To explore the application value of trasound-guided fine-needle aspiration cytology(US-FNAC)com-bined with calcitonin(CT),chromogranin A(CgA),and thyroglobulin(Tg)in the diagnosis of medullary thyroid carcinoma(MTC).Methods The clinical data,ultrasonic characteristics and cytopathological characteristics of seven cases of MTC diagnosed by US-FNAC and confirmed by histopathology after operation were comprehensively analyzed.After 1-2 smears of fine needle aspiration specimens were made,the smears were dried naturally,and then quickly stained with Liu’s staining solution.Rapid on-site evalua-tion(ROSE)was carried out by cytophology to ensure satisfactory cell volume.Meanwhile,the remaining samples were injected into liquid-based cell preservation solution,liquid-based thin layers were prepered,HE staining and immunohistochemical staining of CT,CgA and Tg were performed.Results The number of cells in 7 cases of MTC was moderate to large,there were all scattered in prom-inent large,binuclear,plasmic-like,or nuclear-biased irregular cells;six with spindle cells,and the microscopic characteristics of the cells were basically consistent with the cytological diagnostic criteria of MTC.CT and CgA showed diffuse strong positive expression in cytoplasm,but Tg was negative,and the cytopathological diagnosis was MTC.Conclusion US-FNAC can improve the sample satis-faction of fine needle aspiration of thyroid nodules.Combined with fluid based thin layer preparation and CT,CgA immunocytochemi-cal staining,the accuracy of preoperative diagnosis of MTC can be improved,which has great clinical significance for the treatment of MTC.

关 键 词：甲状腺髓样癌 US-FNAC 免疫组织化学染色 

分 类 号：R736.1[医药卫生—肿瘤]