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目的探讨细胞角蛋白19(CK19)、Galectin-3和HBME-1在甲状腺乳头状癌(PTC)和乳头状增生性甲状腺疾病鉴别诊断中的作用。方法应用免疫组织化学方法检测了44例PTC、27例结节性甲状腺肿伴乳头状增生(NGWPH)和40例甲状腺腺瘤伴乳头状增生(FAWPH)中单克隆抗体CK19、Galectin-3和HBME-1的表达。结果 CK19、Galectin-3和HBME-1在PTC中的阳性表达率分别为100%、97.7%和95.5%,均明显高于NGWPH中的11.1%、7.4%和3.7%,或FAWPH中的12.5%、2.5%和10.0%(P<0.01)。同一病例有两种以上阳性表达在PTC为97.7%,明显高于NGWPH和FAWPH的11.1%和7.5%(P<0.01)。结论 CK19、Galectin-3和HBME-1的检测,尤其是联合检测,对甲状腺良、恶性病变的诊断及鉴别诊断具有较高的临床使用价值。
Objective To investigate the role of cytokeratin 19 (CK19), Galectin-3 and HBME-1 in the differential diagnosis of papillary thyroid carcinoma (PTC) and papillary proliferative thyroid disease. Methods Immunohistochemistry was used to detect the expression of monoclonal antibodies CK19, Galectin-3 and HBME in 44 cases of PTC, 27 cases of nodular goiter with papillary hyperplasia (NGWPH) and 40 cases of thyroid adenoma with papillary hyperplasia (FAWPH) -1 expression. Results The positive rates of CK19, Galectin-3 and HBME-1 in PTC were 100%, 97.7% and 95.5%, respectively, which were significantly higher than those of 11.1%, 7.4% and 3.7% in NGWPH or 12.5% , 2.5% and 10.0% (P <0.01). In the same case, two or more positive expressions were found in PTC (97.7%), significantly higher than those in NGWPH and FAWPH (11.1% vs 7.5%, P <0.01). Conclusion The detection of CK19, Galectin-3 and HBME-1, especially combined detection, has high clinical value in the diagnosis and differential diagnosis of benign and malignant thyroid lesions.