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目的 探讨甲状腺微小乳头状癌的临床病理特点。方法 常规病理检查 4 0 0例经手术切除的甲状腺良性疾病标本 ,筛选出微小癌病例 ,应用光镜观察其形态改变 ,并用SP法检测甲状腺球蛋白 (Tg)、细胞角蛋白 (CK 34βE12 )、上皮膜抗原 (EMA)的表达特点。 结果 4 0 0例中共检出微小乳头状癌 19例 ,检出率为 4 8%。具有诊断意义的主要组织学特征为毛玻璃状 (透明 )细胞核 ;核内假包涵体 ;核沟 ;纤维性间质反应或砂砾体。免疫组化标记 17例高分子质量细胞角蛋白、16例上皮膜抗原、19例甲状腺球蛋白均呈 (+)。结论 甲状腺微小乳头状癌为乳头状癌变型的特殊表现。高分子质量角蛋白和上皮膜抗原表达强阳性对于诊断具有较高的特异性。
Objective To investigate the clinicopathological features of thyroid papillary carcinoma. Methods The pathological examination of 400 cases of thyroid benign diseases was performed to screen out the micro-cancer. The morphological changes were observed with light microscope. The levels of thyroglobulin (Tg), cytokeratin (CK 34βE12) Epithelium membrane antigen (EMA) expression characteristics. Results Totally 19 cases of microscopic papillary carcinoma were detected in 40 cases, the detection rate was 48%. The major histological features of diagnostic significance are frosted glassy (clear) nuclei; pseudonuclear inclusions; nuclear ditch; fibrous interstitial or gritty bodies. Immunohistochemical staining of 17 cases of high molecular mass cytokeratin, 16 cases of epithelial membrane antigen, 19 cases of thyroglobulin were (+). Conclusion The small thyroid papillary carcinoma is a special manifestation of papillary carcinoma. The strong positive expression of macromolecular keratin and epithelial membrane antigen is of high specificity for diagnosis.