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目的探讨CK19、TPO、CD56及p63标记在甲状腺良恶性乳头状增生中的表达及其在诊断与鉴别诊断中的价值。方法采用免疫组化SP法检测61例甲状腺乳头状癌(pa-pillary thyroid carcinoma,PTC)与28例良性乳头状增生(be-nign papillary hyperplasia,BPH)中CK19、TPO、CD56及p63的表达。结果 CK19、TPO、CD56及p63在PTC中的阳性率分别是77%、9%、16%、21%,而其在BPH中的阳性率分别是11%、86%、68%、43%,四者在PTC与BPH中的阳性率差异有显著性(P<0.05)。CK19、TPO、CD56及p63用于PTC诊断时的灵敏度分别是77%、9%、16%、21%,特异度分别是89%、14%、32%、57%,联合应用时灵敏度及特异度分别是89%、93%。四者用于BPH诊断时灵敏度分别是8%、86%、68%、43%,特异度分别是23%、92%、84%、79%,联合应用时灵敏度及特异度分别是96%、100%。结论 CK19与TPO、CD56、p63相比较,用于PTC诊断时的灵敏度及特异度均高于BPH,可作为PTC诊断的重要标记物,而TPO、CD56、p63可作为BPH诊断的重要标记物。同时,四者在良恶性乳头状增生中的阳性表达率差异具有显著性,可应用于甲状腺良恶性乳头状增生的鉴别诊断,联合应用价值更高。
Objective To investigate the expression of CK19, TPO, CD56 and p63 in benign and malignant papillary hyperplasia of thyroid gland and its value in the diagnosis and differential diagnosis. Methods Immunohistochemical SP method was used to detect the expression of CK19, TPO, CD56 and p63 in 61 cases of pa-pillary thyroid carcinoma (PTC) and 28 cases of benign papillary hyperplasia (BPH). Results The positive rates of CK19, TPO, CD56 and p63 in PTC were 77%, 9%, 16% and 21%, respectively, while their positive rates in BPH were 11%, 86%, 68% and 43% The positive rates of the four in PTC and BPH were significantly different (P <0.05). The sensitivity of CK19, TPO, CD56 and p63 for PTC diagnosis was 77%, 9%, 16% and 21% respectively, and the specificity was 89%, 14%, 32% and 57% respectively. The sensitivity and specificity Degrees were 89%, 93%. The sensitivities of the four for BPH diagnosis were 8%, 86%, 68%, 43% and specificity of 23%, 92%, 84%, 79% respectively. The sensitivity and specificity of the four methods were 96% 100%. Conclusions Compared with TPO, CD56 and p63, the sensitivity and specificity of CK19 in diagnosis of PTC are higher than that of BPH, which can be used as an important marker in the diagnosis of PTC. TPO, CD56 and p63 can be used as important markers in the diagnosis of BPH. At the same time, the positive expression rate of the four in benign and malignant papillary hyperplasia was significant, which could be used in the differential diagnosis of benign and malignant papillary hyperplasia of thyroid glands with higher combined value.