Cytokeratin 19、HBME-1和Galectin-3在甲状腺乳头状癌诊断中的应用

目的 探讨Cytokeratin 19（CKl9）、HBME-1和Galectin-3在甲状腺乳头状癌和乳头状增生性甲状腺疾病鉴别诊断中的作用.方法 收集289例甲状腺切除标本,包括144例经典型乳头状癌（CPC）、21例滤泡型乳头状癌（FVPC）、19例乳头状微小癌（PM）、46例结节性甲状腺肿伴乳头状增生（NGWPH）和59例甲状腺腺瘤伴乳头状增生（FAWPH）,采用EnVision二步法检测CKl9、HBME-1和Galectin-3的表达.结果 CK19、HBME-1和Galectin-3在CPC中的阳性表达率分别为100%、93.1%和89.6%,在FVPC中为100%、76.2%和76.2%,在PM中为100%、73.7%和78.9%,在NGWPH中为5.1%、2.2%和4.3%,在FAWPH中为4.3%、1.7%和5.1%.CKl9、HBME-1和Galectin-3的阳性表达率在乳头状癌与乳头状增生性甲状腺疾病之间比较,差异均有统计学意义（P〈0.01）.结论 在甲状腺乳头状癌鉴别诊断中,CK19的敏感性较高,HBME-1和Galectin-3特异性较强;三种抗体联合应用,有助于鉴别甲状腺乳头状癌与乳头状增生.

Application of Cytokeratin 19, HBME-1 and Galectin-3 in diagnosis of thyroid papillary carcinoma

Objective To investigate the value of Cytokeratin 19 ( CK19), HBME-1 and Galectin-3 in differential diagnosis of papillary carcinoma of thyroid and thyroid disease with papillary hyperplasia. Methods The specimens of 289 cases of thyroid lesions, including 144 cases of classic papillary carcinoma (CPC), 21 cases of follicular variant papillary carcinoma ( FVPC), 19 cases of papillary microcarcinoma (PM), 46 cases of nodular goiter with papillary hyperplasia ( NGWPH) and 59 cases of follicular adenoma with papillary hyperplasia (FAWPH) were collected. The expression of CK19, HBME-1 and Galectin-3 was detected by EnVision system. Results CK19, HBME-1 and Galectin-3 expressed in 100%, 93.1% and 89.6% of CPC, in 100%, 76.2% and 76. 2% of FVPC, in 100%, 73.7% and 78. 9% of PM, in 5.1%, 2.2% and 4.3% of NGWPH, and in 4. 3%, 1.7% and 5.1% of FAWPH, respectively. There were significant differences between thyroid papillary carcinoma and thyroid diseases with papillary hyperplasia in expression of CK19, HBME-1 and Galectin-3 (P<0.01). Conclusion CK19 is a sensitive marker for thyroid papillary carcinoma, and HBME-1 and Galectin-3 are better in specificity. This panel of markers is useful to differentiate papillary carcinoma of thyroid from thyroid papillary hyperplasia.