甲状腺乳头状癌的诊断及转移相关的免疫组化研究

目的：评价CK19、p53和p63在鉴别甲状腺良恶性（乳头状癌）病变中的临床应用价值;了解p53、p63、cerbB-2和nm23与甲状腺乳头状癌转移的关系。方法：用免疫组织化学方法,检测57例甲状腺乳头状癌和57例甲状腺良性病变中CK19、p53和p63的表达及甲状腺乳头状癌中cerbB-2和nm23的表达。结果：CK19在甲状腺乳头状癌中的阳性率为91.2%,在良性病变中的阳性率1.76%;p53在甲状腺乳头状癌中的阳性率89.5%,在良性病变中的阳性率17.5%;p63在甲状腺乳头状癌中的阳性率22.8%,在良性病变中的阳性率12.3%。甲状腺乳头状癌中,cerbB-2阳性率为84.2%,nm23阳性率为91.2%,cerbB-2和nm23的表达强度呈正相关。p53、p63、cerbB-2和nm23在转移组和非转移组表达的阳性率差异无统计学意义（P〉0.05）。结论：CK19和p53在甲状腺乳头状癌中表达率极高,是甲状腺乳头状癌病理诊断中非常有价值的辅助诊断指标;p63对鉴别甲状腺良恶性病变无明确意义;在甲状腺乳头状癌中cerbB-2和nm23的表达强度呈正相关;p53,p63,cerbB-2,nm23与甲状腺乳头状癌的转移无明显相关。

Immunohistochemistry related to the diagnosis and metastasis of papillary thyroid carcinoma

OBJECTIVE: To estimate the clinical value of CK19, p53, and p63 on distinguishing benign and malignant thyroid diseases and get further knowledge about the relationship between p53, p63, cerbB-2, nm23 and papillary thyroid carcinoma (PTC) metastasis. METHODS: By the immunohistochemical method called Elivision, CK19, p53, p63, cerbB-2 and nm23 were examined respectively in 57 PTC and 57 thyroid benign disease patients. RESULTS: CK19 expression rates in PTC and benign disease of thyroid were 91.2% and 1.76%, respectively; p53 expressions in PTC and benign disease were 89.5% and 17.5%, respectively. The p63 positive rates were 22.8% and 12.3% in PTC and benign disease, respectively. There were no statistical differences in the expressions of p53, p63, cerbB-2 and nm23 between the metastasis group and non-metastasis group(P>0.05). The positive rates of cerbB-2 and nm23 in PTC were 84.2% and 91.2%, respectively. CONCLUSIONS: CK19 and p53 are valuable assistant diagnostic points for PTC pathological diagnosis. p63 has no explicit value for distinguishing diagnosis of benign or malignant diseases in thyoid. p53, p63, cerbB-2 and nm23 have no relationship with metastasis of PTC. cerbB-2 expression degrees are positively related to nm23.