甲状腺增生性病变中CK19、TPO、Galectin-3的表达及在病理诊断中的应用

目的:检测甲状腺增生性病变中CK19、TPO、Galectin3的表达情况,并评价其在甲状腺增生性病变诊断与鉴别诊断中的价值。方法:利用免疫组织化学染色EnVision二步法,对120例甲状腺病变组织中CK19、TPO、Galectin3蛋白的表达情况进行检测。结果:58例甲状腺乳头状癌(经典型乳头状癌+滤泡型乳头状癌)中,CK19、Galectin3阳性率均为100%(58/58);TPO阴性率约为84.5%(49/58)。25例滤泡性癌、15例甲状腺滤泡性腺瘤及15例结节性甲状腺肿,CK19、Galectin3多为阴性或弱阳性,而TPO均为阳性。CK19、TPO、Galectin3在经典型乳头状癌与良性增生(滤泡性腺瘤+结节性甲状腺肿)之间,滤泡型乳头状癌分别与滤泡性癌、滤泡性腺瘤之间进行比较,P<0.05,差异有显著性;而滤泡性癌与滤泡性腺瘤之间比较,P>0.05,差异无显著性。结论:CK19、TPO、Galectin3均有助于甲状腺乳头状癌与甲状腺良性增生的诊断与鉴别诊断;有助于甲状腺滤泡型乳头状癌与滤泡性癌的诊断与鉴别诊断;但对滤泡性癌与滤泡性腺瘤之间的诊断与鉴别诊断帮助不大;CK19、TPO、Galectin3联合检测有助于提高甲状腺增生性病变的诊断准确率。

The Expression and Diagnostic Value of CK19, TPO, Galectin-3 in Thyroid Lesions

Objective:To detect the expression of CK19,TPO,Galectin-3 and to assess the value of CK19,TPO,Galectin-3 in diagnosis and differential diagnosis in malignant and benign thyroid lesions.Methods:EnVision immunohistochemical technique was performed to detect the expression of CK19,TPO,Galectin-3 in 120 thyroid lesions.Results:In 58 thyroid papillary carcinomas (classic and follicular variant of papillary carcinoma),positive rates of CK19, Galectin-3 were 100%(58/58),and negative rate of TPO was 84.5%(49/58);Most of 25 follicular carcinomas,15 adenomas,15 nontoxic multinodular goiter were negative or weak expressive in the cytoplasm for CK19 or Galectin-3; and were all positive for TPO.In the expression of CK19,TPO, Galectin-3,comparing classic variant of papillary carcinoma with benign lesions(adenoma and nontoxic multinodular goiter),follicular variant of papillary carcinoma with follicular carcinoma, follicular adenoma,respectively, there were significant differences(all P<0.05);but there was no significant difference when comparing follicular carcinoma with follicular adenoma. Conclusion:The results of this study show that immunohistochemical stains of CK19,TPO,Galectin-3 was useful for diagnosis and differential diagnosis in classic variant of papillary carcinoma with benign lesions,and in follicular variant of papillary carcinoma with follicular carcinoma, follicular adenoma, respectively.Combination of CK19,TPO,Galectin-3 can improve the rate of correct diagnosis in thyroid lesions of malignant and benign hyperplasia.