CK19,S-100和EMA在鉴别甲状腺乳头状癌与乳头状增生中的作用

目的：评估检测CK19、S-100蛋白和EMA在诊断甲状腺乳头状癌、滤泡性癌及乳头状增生中的作用。方法：65例甲状腺病变组织分别用CK19、S-100、EMA进行免疫组化染色。结果：在乳头状增生中，CK19、S-100和EMA均不表达。CK19在乳头状癌包括滤泡型乳头状癌中100％表达，在滤泡性癌中有22％的表达。S-100和EMA在经典型乳头状癌分别为61％、100％；滤泡型乳头状癌38％、54％和滤泡性癌44％，11％。结论：CK19结合S-100和EMA检查在诊断甲状腺病变中是有用的辅助手段。CK19在区分甲状腺乳头状癌和乳头状增生中是一个很好的标志物。

Differential diagnostic usefulness of CK19,S-100 protein and EMA in papillary carcinoma and papillary hyperplasia

Purpose: To evaluate the diagnostic utility of detection of Cytokeratin 19 (CK19), b-100 protein and epithelial membrane antigen ( EMA) in thyroid papillary carcinoma, follicular carcinoma and papillary hyperplasia. Methods: 65 thyroid lesions were stained immunohistochemically for CK19, S-100 protein and EMA. Results: CK19, S-100 and EMA are negative in all papillary hyperplasia. CK19 expression was strong and diffuse in 100% of papillary carcinoma including the follicular variant of papillary carcinoma, and was positive in 22% of follicular carcinoma. S-100 and EMA were respectively present in 61% and 100% of classic papillary carcinoma, in 38% and 54% of follicular variant of papillary carcinoma and in 44% and 11 % of follicular carcinoma. Conclusions: Our observations suggest that the expression of CK19, in combination with S-100 and EMA expression, is helpful in the diagnosis of thyroid lesions. CK19 is a valuable marker in the distinction of papillary carcinomas from papillary hyperplasia.