CD56、Galectin-3、CK19及HBME-1蛋白在诊断甲状腺乳头状微小癌和非典型滤泡上皮增生中的价值

目的 探讨CD56、半乳糖凝集素-3（Galectin-3）、细胞角蛋白19（Cytokeratin 19，CK19）和人骨髓内皮细胞标记物（HBME-1）蛋白表达对鉴别甲状腺乳头状微小癌（PTMC）与甲状腺良性病变中非典型滤泡上皮增生（AFEP）的临床应用价值。方法比较CD56、Galectin-3、CK19及HBME-1蛋白在PTMC组和甲状腺良性病变中伴AFEP组病例中阳性率和染色强度模式之间的差异。结果CD56蛋白在PTMC组中的阳性率为66%，且染色强度呈弱阳性表达模式，阳性率和阳性表达强度均显著低于AFEP组（P<005）。而PTMC组中Galectin-3、CK19和HBME-1蛋白阳性率分别为1000%、1000%和888%，阳性染色强度中至强阳性分别为956%、1000%和600%，阳性率和染色强度均显著高于AFEP组（P<005）。PTMC组中Galectin-3/CK19、CK19/HBME-1和Galectin-3/HBME-1双组合的阳性率分别为1000%（45/45）、888%（40/45）和888%（40/45）。在区分PTMC与AFEP的鉴别诊断中，CD56阴性、Galectin-3/CK19双阳性组合诊断PTMC的特异度为934%（42/45）且以中至强阳性染色模式为主。结论在CD56阴性状态下，Galectin-3/CK19或CK19/HBME-1、Galectin-3/ HBME-1双组合同时阳性及表达阳性率和阳性强度对诊断甲状腺乳头状微小癌有重要意义。

The application of CD56, Galectin-3, CK19 and HBME-1 in the diagnosis of thyroid papillary microcarcinoma and atypical follicular epithelial hyperplasia

Objective To investigate the clinical significance of CD56, Galectin-3, cytokeratin19 (CK19) and human bone marrow endothelial cell markers (HBME-1) in differentiating papillary thyroid microcarcinoma (PTMC) from atypical follicular epithelial hyperplasia (AFEP) in benign thyroid lesions. Methods The positive rates and staining intensity patterns of CD56, Galectin-3, CK19 and HBME-1 in patients with benign thyroid disease in PTMC group were compared with those in AFEP group. Results The positive rate of CD56 protein in PTMC group was 6.6%, and the staining intensity showed weakly positive expression. Both the positive rate and positive expression intensity were significantly lower than those in AFEP group (P<005). The positive rates of Galectin-3, CK19 and HBME-1 in the PTMC group were 1000%, 1000% and 888%, respectively; and the positive staining intensities of Galectin-3, CK19 and HBME-1 were 956%, 1000% and 600%, respectively, which were significantly higher than those in the AFEP group (P<005). The positive rates of Galectin-3/CK19, CK19/HBME-1 and Galectin-3/HBME-1 in the PTMC group were 1000% (45/45), 888% (40/45) and 888% (40/45), respectively. In the diagnosis which differentiate PTMC and AFEP, the specificity of CD56 negative and Galectin-3 /CK19 double positive combination in the diagnosis of PTMC was 934% (42/45), it was dominated by the pattern of medium to strong positive staining. Conclusion With negative CD56, Galectin-3/CK19 or CK19/HBME-1 and Galectin-3/HBME-1 dual combination is positive at the same time, and the positive rate and the positive intensity are important for the diagnosis of papillary thyroid microcarcinoma.