微小病毒B19感染与甲状腺乳头状癌的关系

目的：探讨人类微小病毒B19感染（parvovirus B19，B19）与甲状腺乳头状癌（Papillary thyroid carcinoma,PTC）的关系。方法：对38例手术切除的PTC患者甲状腺组织（其中30例伴有周围正常甲状腺组织）及16例甲状腺腺瘤患者腺瘤旁正常甲状腺组织，分别用巢式聚合酶链反应（nested polymerase chain reaction，nPCR）、原位杂交（in situ hybridization，ISH）和免疫组织化学（immunohistochemistu，IHC）检测B19病毒DNA和病毒蛋白的表达。结果：nPCR扩增出173bp的B19特异性目的条带。ISH和IHC检测出B19病毒DNA和蛋白分别位于肿瘤细胞胞核和胞浆内在PTC中，nPCR、ISH和IHC阳性率分别为97.4％（37／38）、78.9％（30／38）和63.2％（24／38）．而腺瘤旁正常甲状腺组织中，阳性率分别为43．8％（7／16）、12．5％（2／16）和6．25％（1／16）：两者比较差异有统计学意义（3种方法均P〈0．001）：癌旁甲状腺组织ISH和IHC阳性率分别为23.3％（7／30）和10．0％（3／30），与之相对应的30例PTC（ISH：80．0％；IHC：60．0％）相比，差异有统计学意义（两者均P〈0.001）。结论：PTC患者甲状腺肿瘤组织中B19感染率明显高于腺瘤旁和癌旁正常甲状腺组织，提示B19感染在PTC的发生中可能起重要的作用。

The Association between Parvovirus B19 Infection and Papillary Thyroid Carcinoma

Objective:To explore the association between parvovirus B19 infection and the pathogenesis of papillary thyroid carcinoma(PTC) .Methods:The levels of B19 DNA and virus protein were determined in tissue blocks of dissected thyroid from 38 PTC patients(30/38 cases also have normal paraneoplastic tissues) and normal paraneoplastic thyroid tissues from 16 patients with adenoma,using nested polymerase chain reaction(nPCR) ,in situ hybridization(ISH) and immunohistochemistry(IHC) techniques simultaneously,in a double blind manner.Results:A B19-specific DNA fragment of 173 bp was amplified using nPCR.The ISH and IHC detection showed that the B19 DNA and virus protein mainly localized to the cell nucleus and cytoplasm.In the PTC cases,the positive rate of the nPCR,ISH and IHC was 97.4%(37/38) ,78.9%(30/38) and 63.2%(24/38) ,respectively,whereas the positive rate was only 43.8%(7/16) ,12.5%(2/16) and 6.25 %(1/16) in normal paraneoplastic thyroid tissues.There was a significant difference between the two groups(for the mean of the 3 parameters,P<0.001) .The positive rate of ISH and IHC in the normal paraneoplastic thyroid tissues from PTC patients was 23.3%(7/30) and 10%(3/30) ,respectively.There was a significant difference between the two parameters when compared to the 30 cases with PTC(ISH:80.0%(24/30) ;IHC:60.0%(18/30) ;both,P<0.001) .Conclusion:Papillary thyroid carcinoma has a higher B19 infection rate compared to the controls,suggesting that B19 infection may play an important role in the pathogenesis of PTC.