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目的探讨细胞角蛋白19(CK19)、半乳糖凝集素3(Galectin-3)、甲状腺过氧化物酶(TPO)和CD56对甲状腺良、恶性病变鉴别诊断的价值。方法应用免疫组化染色检测CK19、Galectin-3、TPO和CD56在92例甲状腺乳头状癌组织(PTC组)和67例甲状腺良性病变组织(良性病变组)中的表达情况。结果 CK19、Galectin-3和TPO阳性表达部位在细胞质内,CD56阳性表达部位在细胞膜和/或细胞质。PTC组CK19和Galectin-3的阳性率均高于良性病变组,而TPO和CD56阳性率均低于良性病变组(P<0.01)。CK19、Galectin-3、TPO和CD56诊断PTC的灵敏度分别为97.8%、76.1%、79.3%和95.7%;特异度分别为56.7%、56.7%、94.0%和67.2%;联合检测2个指标诊断PTC的灵敏度几乎达到100%。结论联合检测CK19、Galectin-3、TPO和CD56可明显提高鉴别诊断甲状腺良、恶性病变的准确性。
Objective To investigate the diagnostic value of cytokeratin 19 (CK19), galectin-3, thyroid peroxidase (TPO) and CD56 in benign and malignant thyroid lesions. Methods The expression of CK19, Galectin-3, TPO and CD56 in 92 cases of thyroid papillary carcinoma (PTC) and 67 cases of benign thyroid lesions (benign lesions) were detected by immunohistochemistry. Results The positive expression sites of CK19, Galectin-3 and TPO were in the cytoplasm, and the positive expression of CD56 was in the cell membrane and / or cytoplasm. The positive rates of CK19 and Galectin-3 in PTC group were higher than those in benign lesion group, but the positive rates of TPO and CD56 in PTC group were lower than those in benign lesion group (P <0.01). The sensitivity of CK19, Galectin-3, TPO and CD56 in the diagnosis of PTC was 97.8%, 76.1%, 79.3% and 95.7% respectively; the specificity was 56.7%, 56.7%, 94.0% and 67.2% respectively; The sensitivity is almost 100%. Conclusions The combined detection of CK19, Galectin-3, TPO and CD56 can significantly improve the accuracy of differential diagnosis of benign and malignant thyroid lesions.