多抗F（ab＇）_2－ELISA测定人血清抗TG－Ab_2及意义

为了克服单抗测定甲状腺球蛋白独特型抗体（抗ＴＧ－Ａｂ＿２）的局限性，便于常规检测，我们建立了兔抗ＴＧ多克隆抗体的Ｆ（ａｂ＇）＿２－ＥＬＩＳＡ测定人血清中的抗ＴＧ－Ａｂ＿２．结果其抗ＴＧ－Ａｂ＿２阳性率：甲亢（Ｇｒａｖｅ＇３）为９．９％（７／７１），桥本氏甲状腺炎为４４．４％（４／９），甲状腺瘤为１６．７％（３／１８），ＳＬＥ为９．５％（４／４２），类风湿性关节炎为０％（０／３２），正常人为０％（０／３５）。     

血清抗甲状腺球蛋白抗体和抗甲状腺过氧化物酶抗体检测在甲状腺疾病诊断及甲亢预后判断中的价值

采用放免法检测甲状豚疾病患者抗甲状腺球蛋白抗体（ＴＧＡｂ）和抗甲状腺过氧化物酶抗体（ＴＰＯＡｂ）、并对部分Ｇｒａｖｅｓ病患者停药后随诊一年的结果进行分析。结果显示：（１）自身免疫性甲状腺疾病患者ＴＧＡｂ和ＴＰＯＡｂ活性及阳性率明显高于非ＡＩＴＤ，尤以桥本甲状腺炎为然。（２）ＧＤ治疗前及停药时ＴＧＡｂ和ＴＰＯＡｂ均阴性者与均阳性者停药一年内的复发率分别为０．５８３和０．２３１。（３）ＴＧＡｂ和ＴＰＯＡｂ均阴性，而停药时甲状腺刺激抗体（ＴＳＡｂ）阳性者，停药时ＧＤ复发的机率最大（０．９０９），提示ＴＧＡｂ和ＴＰＯＡｂ检测在ＡＩＴＤ诊断，鉴别诊断以及ＧＤ预后判断中具有重要的临床意义。     

血清抗甲状腺球蛋白抗体和抗甲状腺过氧化物酶抗体检测在？…

采用放免法检测甲状腺疾病患者抗甲状腺球蛋白抗体（ＨＴＧＡｂ）和抗甲状腺过氧化物酶抗体（ＴＰＯＡｂ），并对部分Ｇｒａｖｅｓ病患者焦药后随诊一年的结果进行分析。结果显示：（１）自身免疫性甲状腺疾病患者ＴＧＡｂ和ＴＰＯＡｂ活性及阳性率及明显高于ＡＩＴＤ，尤以桥本甲状腺炎为然。（２）ＧＤ治疗前及停药时ＴＧＡｂＴ和ＴＧＡｂ和ＴＰＯＡｂ均阴性者与均阳性者停药一年内的复发率分别为０．５８３和０．２３１。（３）Ｔ     

冷冻保存人甲状腺细胞的活力,功能和临床应用

本文研究冷冻保存不同时间甲状腺细胞的活力、功能及其在甲状腺刺激抗体（ＴＳＡｂ）检测中的应用。结果表明：冻存３、６和１２个月的正常或甲亢甲状腺细胞具有良好的活力，各冷冻时相的细胞对ＴＳＨ刺激生成ｃＡＭＰ的反应性无明显差异，且与未冷冻细胞的反应性相似。以冻存甲亢甲状腺细胞测定血清ＴＳＡｂ．在Ｇｒａｖｅｓ病（ＧＤ）未治组的检出率为０．９１３，而甲状腺腺瘤（甲瘤）组与对照组ＴＳＡｂ均为阴性。这提示冻存一年内的人甲状腺细胞仍保持较好的活性与功能，可以作为甲状腺功能和甲状腺疾病基础与临床研究的材料。     

自身免疫病患者抗精浆免疫抑制物抗体的测定

用ＥＬＩＳＡ法测定血清中抗精浆免疫抑制物抗体（ＳＰＩＭ－Ａｂ），发现系统性红斑狼疮、类风湿性关节炎、混合性结缔组织病、重症肌无力和甲状腺疾病患者血清ＳＰＩＭ－Ａｂ水平与检出率均显著高于对照组（Ｐ＜０．０１）；抗核抗体、抗ｄｓ－ＤＮＡ抗体、抗Ｓｍ、抗ＲＮＰ抗体和类风湿因子与ＳＰＩＭ－Ａｂ无相关性，而抗甲状腺球蛋白抗体（Ａ－ＴＧ）和抗甲状腺微粒体抗体（Ａ－ＴＭ）阳性患者ＳＰＩＭ－Ａｂ水平均显著高于Ａ－ＴＧ、Ａ－ＴＭ阴性者（Ｐ＜０．０１）。     

Graves病患者甲状腺和外周静脉血中甲状腺特异性抗体的对比研究

本文对比研究１１例Ｇｒａｖｅｓ病（ＧＤ）和９例非ＧＤ患者甲状腺静脉血（ＴＶＢ）和外周静脉血（ＰＶＢ）中甲状腺刺激抗体（ＴＳＡｂ）、甲状腺球蛋白抗体（ＴＧＡｂ）和甲状腺过氧化物酶抗体（ＴＰＯＡｂ）的活性和Ｔ３、Ｔ４浓度。结果显示：（１）抗体阳性的ＧＤ患者，其ＴＶＢ中ＴＳＡｂ、ＴＧＡｂ和ＴＰＯＡｂ水平均显著高于ＰＶＥ的，ＰＶＢ和ＴＶＢ的ＴＳＡｂ活性呈显著正相关，这提示甲状腺本身是甲状腺特异性抗体产生的主要部位；（２）ＧＤ组和非ＧＤ组ＴＶＢ和ＰＶＢ的血清Ｔ３、Ｔ４不形成浓度梯度；（３）ＴＳＡｂ、ＴＧＡｂ和ＴＰＯＡｂ活性及其在ＴＶＢ和ＰＶＢ之间的活性梯度，与ＴＶＢ和ＰＶＢ中Ｔ３、Ｔ４浓度均无相关关系。     

Graves病患者治疗前、后血清甲状腺刺激抗体和TSH结合抑制免疫球蛋白活性的观察

本文研究了Ｇｒａｖｅｓ病（ＧＤ）患者在抗甲状腺药物（ＡＴＤ）治疗前、后血清甲状腺刺激抗体（ＴＳＡｂ）和ＴＳＨ结合抑制免疫球蛋白（ＴＢＩＩ）的变化，发现治疗前ＴＳＡｂ和ＴＢＩＩ的检出率分别为９１．７％和７９．２％，治疗后两抗体的活性及阳性率均显著下降，表明抗甲状腺药可改善ＧＤ患者的免疫异常。ＴＳＡｂ和ＴＢＩＩ活性不相关，提示ＴＳＨ受体抗体（ＴＲＡｂ）具有异质性。ＴＳＡｂ和ＴＢＩＩ活性与血清甲状腺激素水平无相关关系，说明体外测定的ＴＳＡｂ或／和ＴＢＩＩ活性并不能完全反映甲亢的严重程度。     

Graves病患者治疗前,后血清甲状腺激素抗体和TSH结合抑制免疫？…

本文研究了Ｇｒａｖｅｓ病（ＧＤ）患者在抗甲状腺药物（ＡＴＤ）治疗前、后血清甲状腺刺激抗体（ＴＳＡｂ）和ＴＳＨ结合抑制免疫球蛋白（ＴＢＩＩ）的变化，发现治疗前ＴＳＡｂ和ＴＢＩＩ的检出率分别为９１．７％和７９．２％，治疗后两抗体的活性及阳笥率均显著下降，表明抗甲状腺药可改善ＧＤ患者的免疫异常。ＴＳＡｂ和ＴＢＩＩ活性不相关，提示ＴＳＨ受体抗体（ＴＲＡｂ）具有异质性。ＴＳＡｂ和ＴＢＩＩ活性与血清甲状腺激素     

多抗F（ab‘）2—ELISA测定人血清抗TG—Ab2及意义

为了克服单抗测定甲状腺球蛋白独特型抗体的局限性，便于常规检测，我们建立了兔抗ＴＧ多克隆抗体的Ｆ（ａｂ）２－ＥＬＩＳＡ测定人血清中的ＴＧ－Ａｂ２。结果其抗ＴＧ－Ａｂ２阳性率；甲亢为９．９％，桥本氏甲状腺炎为４４．４％，甲状腺瘤为１６．７％，ＳＬＥ为９．５％，类风湿性关节炎为０％，正常人为０％。     

人清浆对抗原抗体反应免疫抑制作用的研究

本用体外实验的方法，研究人精浆对抗原抗体特异怀反应的抑制作用。运用酶联免疫吸附试验原检测人精浆对ＡｓＡｂ，Ａ－ｄｓＤＮＡ，Ａ－ＴＧ，Ａ－ＴＭ，ＲＦ五种自身抗体的抑制，抑制率分别为６１．５±２３．１（％），５７．１±２５．８（％），４２．０±２８．２（％），４１．８±２５．１（％），说明均有明显的抑制作用。经生育组与孕组、流产组对比分析发现不孕组精浆对ＲＦ２５．１（％），说明均有明显的抑制作用。经     

Occult thyroid carcinoma: a rare case report and review of literature

Occult thyroid carcinoma is very common in the clinic and is generally divided into four groups. Here, we proposed two types of occult thyroid carcinoma as the fifth group. The first type was locoregional lymph node metastases from thyroid carcinoma, and the second type was distant organ metastases from thyroid carcinoma. The unique aspect of the fifth group was that the primary carcinoma of the fifth group was not finally found by pathological examination. To better understand the fifth group, we reported a typical case. Furthermore, we discussed the diagnostic criteria and procedures and the management of the fifth group of occult thyroid carcinoma.     

Molecular pathology of thyroid tumours of follicular cells: a review of genetic alterations and their clinicopathological relevance

Thyroid cancer is the most common endocrine malignancy. Knowledge of the molecular pathology of thyroid tumours originating from follicular cells has greatly advanced in the past several years. Common molecular alterations, such as BRAF p.V600E, RAS point mutations, and fusion oncogenes (RET–PTC being the prototypical example), have been, respectively, associated with conventional papillary carcinoma, follicular‐patterned tumours (follicular adenoma, follicular carcinoma, and the follicular variant of papillary carcinoma/non‐invasive follicular thyroid neoplasm with papillary‐like nuclear features), and with papillary carcinomas from young patients and arising after exposure to ionising radiation, respectively. The remarkable correlation between genotype and phenotype shows how specific, mutually exclusive molecular changes can promote tumour development and initiate a multistep tumorigenic process that is characterised by aberrant activation of mitogen‐activated protein kinase and phosphoinositide 3‐kinase–PTEN–AKT signalling. Molecular alterations are becoming useful biomarkers for diagnosis and risk stratification, and as potential treatment targets for aggressive forms of thyroid carcinoma. What follows is a review of the principal genetic alterations of thyroid tumours originating from follicular cells and of their clinicopathological relevance.     

Pitfalls in thyroid tumour pathology

This review provides an itemized listing of major diagnostic pitfalls in the field of thyroid tumour pathology, emphasizing the features that the authors have found most useful in their recognition and avoidance.     

Black thyroid revisited: cytologic diagnosis in fine-needle aspirates is unlikely

We report four patients diagnosed with black discoloration of the thyroid gland at surgery and a fifth patient in which the "black thyroid" was an incidental finding at autopsy. The four patients diagnosed at surgery had prior fine-needle aspirations (FNA), which did not reveal any characteristic pigmentation. One patient presented with cervical lymph node metastases from a papillary microcarcinoma of thyroid. The second patient was diagnosed as a cellular adenomatoid nodule, and suppressive therapy was recommended. She elected to have surgery instead. The third patient underwent surgery because of an oxyphilic cell nodule, in a background of lymphocytic thyroiditis, in which a Hürthle cell neoplasm could not be ruled out. His aspirates were reviewed at two other institutions, and no diagnosis of black thyroid was entertained. The fourth patient had an adenomatoid nodule with cystic change and slightly atypical squamous metaplasia. She decided to have surgery, which revealed a black thyroid. Later, it was discovered that the patients had received minocycline for the treatment of acne. FNA does not seem to be a reliable method to diagnose black thyroid preoperatively. Although this is a striking operative finding, diagnosing it on FNA seems to be unlikely and also inconsequential.     

EGF-receptors in human normal and pathological thyroid tissue

Expression of the epidermal growth factor receptor (EGFR) was studied in cryosections from human thyroid tissues. Normal tissue (4 cases), nodular goitre (12), toxic goitre (9), adenoma (9), follicular carcinoma (1), papillary carcinoma (7) and poorly differentiated carcinoma (1) were used for immunohistochemistry. Northern blot analysis was performed in two nodular goitres, three adenomas, two papillary carcinomas, one follicular carcinoma and the adjacent normal tissue in five cases as well as in two cell lines from anaplastic carcinomas. Epidermal growth factor receptor immunoreactivity was detected in all tissues examined. The amount of EGFR mRNA did not differ between normal and abnormal tissues. However, the EGFR staining was weaker in normal thyroid tissue compared to the adjacent neoplastic areas suggesting an upregulation at the posttranslational level in the latter. A strong staining was also seen in hyperfunctioning thyroid glands. The EGFR location was mainly basal or basolateral in all thyroid tissues with normal histology and in toxic diffuse goitre. Pericellular and sometimes cytoplasmatic staining was seen in neoplastic tissues. In nodular goitre the staining was both basal, lateral and apical and varied in intensity. Our data suggest that a non-polarized location of EGFR probably indicates a loss of the normal epithelial cell polarity and could be interpreted as an early sign of dedifferentiation. Furthermore, a role for the EGFR is proposed, not only in the development of thyroid neoplasias but also in goitre formation.     

Thyroid neoplasms of follicular cell derivation: A simplified approach

Thyroid tumors of follicular cell derivation are increasing in incidence. These lesions exhibit a spectrum of morphologic and behavioral features that provide the opportunity to understand malignant transformation and progression. Molecular data suggest that the thyroid undergoes a series of genetic alterations that account for the development of the various types of thyroid carcinoma. Our understanding of these tumors has progressed dramatically over the past 50 years and the classification has become complex and cumbersome. We provide a practical approach to clinical diagnosis and propose a simplified classification of these common neoplasms.     

Follicular variant of papillary carcinoma: cytologic findings on FNAB samples-experience with 16 cases

Between January 1, 1992 and December 31, 1997, a cytopathological diagnosis of follicular variant of papillary thyroid carcinoma (FVPC) was made on a series of 16 out of 18 patients with palpable nodules who underwent fine-needle aspiration biopsy (FNAB) in our Department. The results of aspiration biopsy were followed by histopathological examination of the surgically excised tissues. There were three false-negative aspirations (16.6%), of which two were probably bound to fine-needle sampling and one due to a mixture of benign and malignant cells which had originally gone unrecognized. The accuracy of the cytopathologic diagnosis in this variant was 88.8%. An analysis of the diagnostic cytopathological criteria was performed, which demonstrated the importance of both architectural features (monolayered and branching sheets, microacinar structures, and their combinations) and nuclear features (presence of nuclear grooves). Background -bound features were mainly represented by dense, nonfilamentous colloid. The cytopathologic findings in FVPC were compared to those found in a series of 10 usual papillary carcinomas (UPC) and 10 follicular neoplasms (FN). These latter had originally been diagnosed by FNAB and were subsequently classified histologically as follicular adenoma (n = 6), follicular carcinoma (n = 3), or adenomatoid colloid nodule (n = 1). Statistical evaluation was performed on the cytopathological findings in the three classes of lesions (FVPC, UPC, and FN) as to their presence and relative frequency or absence by using a nonparametric one-way ANOVA (Kruskall-Wallis) and, where necessary, a Mann-Whitney U test. Papillary cellular fragments and multinucleated giant cells (P < 0.005), nonfilamentous dense colloid, squamoid cells, and syncytia were significantly more represented in UPC than in FVPC (P < 0.05), while histiocytes were significantly more frequent in FVPC (P < 0.005). Other nuclear and/or background features were significant only in the distinction between papillary carcinomas as a group and FN. The cytological differential diagnosis of the FVPC is briefly discussed with relevance to the possible pitfalls caused by its peculiar cyto- and histomorphology.     

Subisthmic accessory thyroid gland in man: A case report and a review of thyroid anomalies

Morphological variations of the thyroid gland are common and generally occur superior to the gland, reflecting its developmental origin. In this report we describe an accessory lobe located inferior to both lateral lobes and the isthmus. The accessory lobe was supplied by a branch of the right inferior thyroid artery and its vein drained via the plexus thyroideus impar. A discussion of thyroid anomalies is presented and a system for classifying variations of thyroid anatomy is proposed. Clin. Anat. 10:341–344, 1997. © 1997 Wiley-Liss, Inc.     

Synchronous papillary thyroid carcinoma and follicular thyroid carcinoma: case report and review of literature

Collision tumor is a term denoting two histologically distinct tumor types occuring at the same anatomic site, which is a rare clinical entity. In the thyroid gland, collision tumors are rare. Here we report a case of the synchronous occurrence of follicular thyroid carcinoma (FTC) and papillary thyroid carcinoma (PTC). The current case report describes a 40-year-old woman with synchronous FTC and PTC. Pathologists and surgeons should be aware of collision tumors to avoid possible misdiagnosis.     

Familial non-medullary thyroid cancer: an update on the genetic and pathologic features

Well differentiated thyroid carcinoma is one of the most increasingly prevalent cancers, and while many are sporadic, some are inherited. These heritable thyroid cancers are grouped as familial non-medullary thyroid carcinoma (FNMTC) and represent approximately 5–10% of non-medullary thyroid carcinomas. While the group of FNMTC is quite heterogeneous, an ever increasing number of attributable genetic changes have been described. In addition to the classic, non-syndromic FNMTC there are also several well defined and characterized genetic syndromes with thyroid cancer as a component. This review will provide an update on the current molecular understanding of both syndromic and non-syndromic heritable thyroid cancer.