CK19与TPO在鉴别甲状腺乳头状癌与甲状腺乳头状增生中的作用

目的探讨CK19与甲状腺过氧化物酶（TPO）蛋白在甲状腺乳头状癌及结节性甲状腺肿伴乳头状增生鉴别诊断中的作用。方法用免疫组化EnVision法测定32例甲状腺乳头状癌及32例结节性甲状腺肿伴乳头状增生的CK19和TPO表达情况。结果32例甲状腺乳头状癌全部CK19（＋）,30例TPO（-）,2例弱（＋）;32例结节性甲状腺肿伴乳头状增生全部TPO（＋）,10例CK19（＋）,22例（-）。CK19和TPO在甲状腺乳头状癌及良性乳头状增生鉴别诊断中的评价指标：敏感度（Sen）分别为100%、93.75%;特异度（Spe）分别为68.75%、100%;准确度（Acc）分别为84.38%、96.88%;阳性预测值（＋PV）76.19%、100%;阴性预测值（-PV）分别为100%、94.12%;序列试验显示,联合测定敏感度为93.75%,特异度为100%。结论CK19和TPO蛋白可作为鉴别甲状腺乳头状癌与良性乳头状增生的重要参考标记物,联合测定效果更好。

Role of cytokeratin 19 and thyroid peroxidase in differential diagnosis of thyroid papillary carcinomas from benign thyroid papillary hyperplasia

Objective To study the role of cytokeratin 19(CK19) and thyroperoxidase(TPO) in the differential diagnosis between papillary thyroid carcinomas and benign thyroid papillary hyperplasia. Methods The expression of CK19 and TPO protien in 32 cases of papillary thyroid carcinomas and 32 cases of thyroid nodular goiter with papillary hyperplasia were dectected by inmmunohistochemistrical EnVision Method. Results Among 32 cases of thyroid papillary carcinomas,all were positive for CK19 and 30 cases were negative for TPO.Among 32 cases of thyroid nodular goiter with papillary hyperplasia,all were positive for TPO,10 cases were positive for CK19,and 22 cases were negative to CK19.The assessed values of CK19 and TPO in the diagnosis of thyroid papillary carcinoma and benign thyroid papillary hyperplasia were below: sensitivity was 100% and 93.75%,specificity was 68.75% and 100%,accuracy was 84.38% and 96.88%,positive predictive value was 76.19% and 100%,and negative predictive value was 100% and 94.12%,respectively.The combined application showed that sensitivity was 93.75% and specificity was 100% respectively. Conclusion CK19 and TPO are useful markers for the differential diagnosis between malignant and benign thyroid papillary hyperplasia.It is better if CK19 is detected together with TPO.