RET、HBME-1和Ki67在甲状腺良、恶性肿瘤中的表达

目的 探讨甲状腺良、恶性肿瘤中RET、HBME-1和Ki67基因蛋白的表达.方法 利用组织芯片技术采用二步法(PV-9000)进行免疫组化染色,检测22例结节性甲状腺肿、7例甲状腺滤泡性腺瘤,47例甲状腺乳头状癌、7例未分化癌、5例髓样癌、4例滤泡性癌、1例低分化岛状癌及1例鳞状细胞癌中上述3种蛋白的表达情况.结果 良性病变与恶性病变中3种蛋白的表达差异均有显著意义(P＜0.01),而良性病变中的不同类型间的差异无显著性(P＞0.05).HBME-1在甲状腺乳头状癌的阳性率高于滤泡性癌、髓样癌及未分化癌的表达,之间均有显著性差异(P＜0.01).Ki67在未分化癌阳性率高于乳头状癌的表达,二者比较差异显著(P＜0.05).结论 RET、HBME-1和Ki67的同时检测可作为良恶性甲状腺肿瘤鉴别诊断的指标,其中以HBME-1的敏感性最佳,RET次之,Ki67高表达可能是去分化、浸润和转移的标志.在甲状腺良性肿瘤中RET、HBME-1和Ki67同时阳性应视为恶变的高危状态.

Expression of RET,HBME-1 and Ki67 in thyroid benign and malignant tumors

Objective To study the expression of RET,HBME-1 and Ki67 proteins in thyroid tumors.Methods By means of tissue chip technique and the immunohistochemical method,22 cases of nodular goiters,7 cases of thyroid adenomas,47 cases of papillary carcinomas,7 cases of undifferentiated carcinoma,5 cases of medullary thyroid carcinoma,4 cases of follicular thyroid carcinomas,1 case of poorly differentiated insular carcinoma and 1 case of squamous thyroid carcinoma were examined to detect the expression of RET,HBME-1 and Ki67.Results There were significant differences between benign and malignant lesions concerning the expression of 3 proteins(P<0.01).The positive rate of malignant groups was higher than that of benign ones,but there was no difference in benign group(P>0.05).The positive rates of HBME-1 in papillary carcinomas was higher compared to other thyroid carcinoma(P<0.01),and the positive rates of Ki67 in undifferentiated carcinoma was higher compared to papillary carcinoma(P<0.05).Conclusion Combined tests of RET,HBME-1 and Ki67 may act to distinguish thyroid benign lesions from malignant tumors in clinical pathology.HBME-1 is more sensitive than RET.The malignant follicular tumors with higher expression of Ki67 indicates dedifferentiation,invasion and metastasis.RET,HBME-1 and Ki67 positive simultaneously should be taken as the high risk state of thyroid carcinoma.