半乳糖凝集素-3和细胞角蛋白19表达在甲状腺穿刺病理诊断中的应用

目的：观察半乳糖凝集素-3(Galectin-3)和细胞角蛋白19（CK19）在甲状腺穿刺标本中表达的特点，分析其在甲状腺良恶性病变鉴别诊断中的应用，探讨免疫组织化学方法标记CK19、Galectin-3表达在甲状腺穿刺小标本病理诊断中应用的可行性。方法：选择20例甲状腺乳头状癌（PTC）及16例甲状腺良性病变(BTL)穿刺组织，观察HE切片病理形态学特点，应用免疫组织化学EnVision法检测标本中Galectin-3、CK19和Ki67蛋白表达，对比3种蛋白在不同组间的表达，分析3种抗体在甲状腺术前穿刺病理诊断中的作用。结果：Galectin-3、CK19和Ki67在PTC组阳性率分别为90%（18/20）、95%（19/20）及60%（12/20），在BTL组阳性率分别为12.5%（2/16，均为弱阳性）、31.25%（5/16，均为弱阳性）及62.5%（10/16）。Galectin-3 和CK19在PTC与BTL组间表达率比较差异有统计学意义（均P<0.01），而Ki67在PTC与BTL组间表达率比较差异无统计学意义（P>0.05）。结论：Galectin-3和CK19蛋白在PTC与BTL的表达存在显著差异，联合检测该2种蛋白在甲状腺乳头状癌穿刺标本的鉴别诊断中具有重要的应用价值，能有效提高甲状腺病变术前穿刺活检的确诊率。

Application of Galectin-3 and CK19 expressions in pathological diagnosis of thyroid puncture biopsy

Objective To observe the expression characteristics of cytoketatin19(CK19) and Galectine-3 in thyroid puncture samples and analyze their applicantion in differential diagnosis for benign and malignant thyroid disorders,and to explore the feasibility of application of Galectine-3 and CK19 in pathological diagnosis of small puncture samples.Methods The puncture tissues from 21 cases of papillary thyroid carcinoma(PTC) and 16 cases of benign thyroid lesions(BTL) were examined by HE section and the expressions of Galectin-3,CK19 and Ki67 were detected by EnVision immunohistochemistry. The different expressions of the three proteins were compared between two groups and their roles in the pathological diagnosis in the puncture samples before thyroid operation were analyzed.Results The positive rates of Galectin-3,CK19 and Ki67 in PTC group was were 90%(18/20),95%(19/20),and 60%(12/20),respectively.The positive rates of the three proteins in BTL group were 12.5%(2/16,mildly positve),31.25%(5/16,mildly positive),and 62.5%(10/16),respectively.There were significant differences of Galectin-3 and CK19 between PTC and BTL groups(P<0.01).There was no significant difference of Ki67 expression between PTC and BTL groups(P>0.05).Conclusion The expressions of Galectin-3 and CK19 are significantly different between PTC and BTL.Combined detection of these two proteins plays an important role in differential diagnosis of PTC and can improve the diagnosis rate of puncture tissue of thyroid disorders before operation.