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目的探讨CK19、galectin-3和syndecan-1抗体在甲状腺乳头状病变诊断与鉴别诊断中的意义。方法选取典型甲状腺乳头状癌(PTC)108例、甲状腺乳头状增生(PTH)35例和不典型甲状腺乳头状增生(PTH-A)17例,通过免疫组化方法检测CK19、galectin-3和syndecan-1表达情况。结果 CK19、galectin-3和syndecan-1在PTC组的阳性率分别为85.2%(92/108)、75%(81/108)、66.7%(72/108);在PTH-A组的阳性率分别为29.4%(5/17)、5.9%(1/17)、11.8%(2/17);在PTH组的阳性率分别为37.1%(13/35)、22.9%(8/35)、2.9%(1/35)。CK19、galectin-3和syndecan-1在PTC中的表达均明显高于PTH(P<0.05)。在PTC的诊断中,syndecan-1的特异性最高(97.1%),CK19的敏感性最高(85.2%)。联合3种抗体中的任意2种均可以将诊断特异性提高至100%。3种抗体在PTH-A和PTH中的表达差异不显著(P>0.05)。结论 CK19不能作为PTC独立的诊断指标;syndecan-1在PTC诊断中具有和galectin-3同样的价值。联合应用galectin-3和syndecan-1并结合组织学特点对甲状腺乳头状病变的鉴别诊断有重要意义。
Objective To investigate the significance of CK19, galectin-3 and syndecan-1 antibodies in the diagnosis and differential diagnosis of papillary thyroid lesions. Methods A total of 108 cases of typical thyroid papillary carcinoma (PTC), 35 cases of papillary thyroid papillary hyperplasia (PTH) and 17 cases of atypical thyroid papillary hyperplasia (PTH-A) were selected. Immunohistochemistry was used to detect CK19, galectin-3 and syndecan -1 expression. Results The positive rates of CK19, galectin-3 and syndecan-1 in PTC group were 85.2% (92/108), 75% (81/108) and 66.7% (72/108) (P <0.05). The positive rates of PTH were 37.1% (13/35), 22.9% (8/35) in PTH group, 2.9% (1/35). The expression of CK19, galectin-3 and syndecan-1 in PTC were significantly higher than those in PTH (P <0.05). In the diagnosis of PTC, syndecan-1 had the highest specificity (97.1%) and CK19 (85.2%). Combining any two of the three antibodies increased diagnostic specificity to 100%. There was no significant difference in the expressions of PTH-A and PTH between the three antibodies (P> 0.05). Conclusion CK19 can not be used as an independent diagnosis of PTC; syndecan-1 has the same value as galectin-3 in the diagnosis of PTC. The combination of galectin-3 and syndecan-1 combined with histological features of thyroid papillary lesions of differential diagnosis of great significance.