• 貴陽醫(yī)學院附屬醫(yī)院甲狀腺外科(貴州貴陽 550004);

目的  分析半乳糖凝集素-3(galectin-3)、人骨髓內(nèi)皮細胞-1(HBME-1)、細胞角蛋白(CK)19及RET在甲狀腺良、惡性腫瘤中的表達情況,探討其在診斷甲狀腺腫瘤中的臨床價值。
方法  收集2009~2012年期間我院甲狀腺外科經(jīng)手術(shù)切除的131例甲狀腺腫瘤患者的臨床病理資料,其中甲狀腺惡性腫瘤患者45例,甲狀腺良性腫瘤患者86例,應(yīng)用免疫組織化學方法檢測galectin-3、HBME-1、CK19及RET在甲狀腺良、惡性腫瘤中的表達情況。
結(jié)果  galectin-3、HBME-1、CK19及RET在45例甲狀腺惡性腫瘤患者中的表達陽性率分別為97.8%(44/45)、88.9%(40/45)、100%(45/45)及71.1%(32/45),均明顯高于其在86例甲狀腺良性疾病患者中的表達陽性率 〔分別為9.3%(8/86)、12.8%(11/86)、37.2%(32/86)及8.1%(7/86)〕,差異均有統(tǒng)計學意義(P<0.05)。galectin-3、HBME-1、CK19及RET診斷甲狀腺良、惡性疾病的靈敏度分別為97.8%、88.9%、100%及71.1%,特異度分別為90.7%、87.2%、62.8%及91.9%,診斷符合率分別為93.1%、87.8%、75.6%及84.7%。
結(jié)論  galectin-3、HBME-1、CK19及RET均在甲狀腺惡性腫瘤中表達增強,是甲狀腺良、惡性疾病病理診斷中有價值的輔助診斷指標,其中g(shù)alectin-3對甲狀腺惡性腫瘤的診斷有較高的參考價值,聯(lián)合檢測可以較大程度上提高甲狀腺癌的診斷率。

引用本文: 黃堃,龔衛(wèi)東,王南鵬,葉暉,周彥,高慶軍,段海松,高榮君,趙代偉. galectin-3、HBME-1、CK19及RET在甲狀腺腫瘤中的表達情況及其臨床價值. 中國普外基礎(chǔ)與臨床雜志, 2013, 20(2): 156-160. doi: 復制

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1. 吳在德, 吳肇漢. 外科學[M]. 北京:人民衛(wèi)生出版社, 2005:313.
2. Hundahl SA, Fleming ID, Fremgen AM, et al. A National CancerData Base report on 53 856 cases of thyroid carcinoma treated in the U. S, 1985-1995[J]. Cancer, 1998, 83(12):2638-2648.
3. Chen AY, Jemal A, Ward EM. Increasing incidence of differentiated thyroid cancer in the United States, 1988-2005[J]. Cancer, 2009, 115(16):3801-3807.
4. Cheung CC, Ezzat S, Freeman JL, et al. Immunohistochemical diagnosis of papillary thyroid carcinoma[J]. Mod Pathol, 2001, 14(4):338-342.
5. Liberman E, Weidner N. Papillary and follicular neoplasms of thethyroid gland. Differential immunohistochemical staining with high-molecular-weight keratin and involucrin[J]. Appl Immunohistochem Mol Morphol, 2000, 8(1):42-48.
6. Saleh HA, Jin B, Barnwell J, et al. Utility of immunohistochemical markers in differentiating benign from malignant follicular-derived thyroid nodules[J]. Diagn Pathol, 2010, 5:9.
7. Park YJ, Kwak SH, Kim DC, et al. Diagnostic value of galectin-3,HBME-1, cytokeratin 19, high molecular weight cytokeratin, cyclin D1 and p27 (kip1) in the differential diagnosis of thyroid nodules[J]. J Korean Med Sci, 2007, 22(4):621-628.
8. Beesley MF, Mclaren KM. Cytokeratin 19 and galectin-3 immuno-histochemistry in the differential diagnosis of solitary thyroid nodules[J]. Histopathology, 2002, 41(3):236-243.
9. Volante M, Bozzalla-Cassione F, Orlandi F, et al. Diagnostic role of galectin-3 in follicular thyroid tumors[J]. Virchows Arch, 2004, 444(4):309-312.
10. de Matos PS, Ferreira AP, de Oliveira Facuri F, et al. Usefulness of HBME-1, cytokeratin 19 and galectin-3 immunostaining in thediagnosis of thyroid malignancy[J]. Histopathology, 2005, 47 (4):391-401.
11. 王洪云, 林均義, 李懷臣. 胸膜間皮瘤的間皮細胞抗原癌胚抗原表達特征及鑒別診斷價值[J]. 中華腫瘤雜志, 2000, 22(5):410.
12. Miettinen M, Kärkkäinen P. Differential reactivity of HBME-1and CD15 antibodies in benign and malignant thyroid tumours. Pref-erential reactivity with malignant tumours[J]. Virchows Arch, 1996, 429(4-5):213-219.
13. van Hoeven KH, Kovatich AJ, Miettinen M. Immunocytochemicalevaluation of HBME-1, CA19-9, and CD-15 (Leu-M1) in fine-needle aspirates of thyroid nodules[J]. Diagn Cytopathol, 1998, 18(2):93-97.
14. Nasr MR, Mukhopadhyay S, Zhang S, et al. Immunohistochemical markers in diagnosis of papillary thyroid carcinoma:Utility of HBME1 combined with CK19 immunostaining[J]. Mod Pathol, 2006, 19(12):1631-1637.
15. Prasad ML, Huang Y, Pellegata NS, et al. Hashimoto’s thyroiditiswith papillary thyroid carcinoma (PTC)-like nuclear alterations express molecular markers of PTC[J]. Histopathology, 2004, 45(1):39-46.
16. Raphael SJ, Mckeown-Eyssen G, Asa SL. High-molecular-weight cytokeratin and cytokeratin-19 in the diagnosis of thyroid tumors[J]. Mod Pathol, 1994, 7(3):295-300.
17. Griffith OL, Chiu CG, Gown AM, et al. Biomarker panel diagnosis of thyroid cancer:a critical review[J]. Expert Rev Anticancer Ther, 2008, 8(9):1399-1413.
18. Fischer S, Asa SL. Application of immunohistochemistry to thyroid neoplasms[J]. Arch Pathol Lab Med, 2008, 132(3):359-372.
19. Prasad ML, Pellegata NS, Huang Y, et al. Galectin-3, fibronectin-1,CITED-1, HBME1 and cytokeratin-19 immunohistochemistry is useful for the differential diagnosis of thyroid tumors[J]. Mod Pathol, 2005, 18(1):48-57.
20. 姜軍, 韓曉蓉. 甲狀腺癌的分子生物學研究進展[J]. 中國普外基礎(chǔ)與臨床雜志, 2000, 7(5):326-327.
21. 王雅輝, 葉暉, 王南鵬, 等. 抑癌基因TIP30在甲狀腺乳頭狀癌中的表達與臨床意義[J]. 中國普外基礎(chǔ)與臨床雜志, 2009, 16(5):356-359.
22. Ito T, Seyama T, Mizuno T, et al. Unique association of p53 mutations with undifferentiated but not with differentiated carcinomas of the thyroid gland[J]. Cancer Res, 1992, 52(5):1369-1371.
23. 高榮君, 王南鵬, 葉暉, 等. KiSS-1在甲狀腺乳頭狀癌中的表達及其臨床意義[J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(8):775-779.
24. Asa SL. The role of immunohistochemical markers in the diagnosis of follicular-patterned lesions of the thyroid[J]. Endocr Pathol, 2005, 16(4):295-309.
25. Fischer AH, Bond JA, Taysavang P, et al. Papillary thyroid carcinoma oncogene (RET/PTC) alters the nuclear envelope and chromatin structure[J]. Am J Pathol, 1998, 153(5):1443-1450.
  1. 1. 吳在德, 吳肇漢. 外科學[M]. 北京:人民衛(wèi)生出版社, 2005:313.
  2. 2. Hundahl SA, Fleming ID, Fremgen AM, et al. A National CancerData Base report on 53 856 cases of thyroid carcinoma treated in the U. S, 1985-1995[J]. Cancer, 1998, 83(12):2638-2648.
  3. 3. Chen AY, Jemal A, Ward EM. Increasing incidence of differentiated thyroid cancer in the United States, 1988-2005[J]. Cancer, 2009, 115(16):3801-3807.
  4. 4. Cheung CC, Ezzat S, Freeman JL, et al. Immunohistochemical diagnosis of papillary thyroid carcinoma[J]. Mod Pathol, 2001, 14(4):338-342.
  5. 5. Liberman E, Weidner N. Papillary and follicular neoplasms of thethyroid gland. Differential immunohistochemical staining with high-molecular-weight keratin and involucrin[J]. Appl Immunohistochem Mol Morphol, 2000, 8(1):42-48.
  6. 6. Saleh HA, Jin B, Barnwell J, et al. Utility of immunohistochemical markers in differentiating benign from malignant follicular-derived thyroid nodules[J]. Diagn Pathol, 2010, 5:9.
  7. 7. Park YJ, Kwak SH, Kim DC, et al. Diagnostic value of galectin-3,HBME-1, cytokeratin 19, high molecular weight cytokeratin, cyclin D1 and p27 (kip1) in the differential diagnosis of thyroid nodules[J]. J Korean Med Sci, 2007, 22(4):621-628.
  8. 8. Beesley MF, Mclaren KM. Cytokeratin 19 and galectin-3 immuno-histochemistry in the differential diagnosis of solitary thyroid nodules[J]. Histopathology, 2002, 41(3):236-243.
  9. 9. Volante M, Bozzalla-Cassione F, Orlandi F, et al. Diagnostic role of galectin-3 in follicular thyroid tumors[J]. Virchows Arch, 2004, 444(4):309-312.
  10. 10. de Matos PS, Ferreira AP, de Oliveira Facuri F, et al. Usefulness of HBME-1, cytokeratin 19 and galectin-3 immunostaining in thediagnosis of thyroid malignancy[J]. Histopathology, 2005, 47 (4):391-401.
  11. 11. 王洪云, 林均義, 李懷臣. 胸膜間皮瘤的間皮細胞抗原癌胚抗原表達特征及鑒別診斷價值[J]. 中華腫瘤雜志, 2000, 22(5):410.
  12. 12. Miettinen M, Kärkkäinen P. Differential reactivity of HBME-1and CD15 antibodies in benign and malignant thyroid tumours. Pref-erential reactivity with malignant tumours[J]. Virchows Arch, 1996, 429(4-5):213-219.
  13. 13. van Hoeven KH, Kovatich AJ, Miettinen M. Immunocytochemicalevaluation of HBME-1, CA19-9, and CD-15 (Leu-M1) in fine-needle aspirates of thyroid nodules[J]. Diagn Cytopathol, 1998, 18(2):93-97.
  14. 14. Nasr MR, Mukhopadhyay S, Zhang S, et al. Immunohistochemical markers in diagnosis of papillary thyroid carcinoma:Utility of HBME1 combined with CK19 immunostaining[J]. Mod Pathol, 2006, 19(12):1631-1637.
  15. 15. Prasad ML, Huang Y, Pellegata NS, et al. Hashimoto’s thyroiditiswith papillary thyroid carcinoma (PTC)-like nuclear alterations express molecular markers of PTC[J]. Histopathology, 2004, 45(1):39-46.
  16. 16. Raphael SJ, Mckeown-Eyssen G, Asa SL. High-molecular-weight cytokeratin and cytokeratin-19 in the diagnosis of thyroid tumors[J]. Mod Pathol, 1994, 7(3):295-300.
  17. 17. Griffith OL, Chiu CG, Gown AM, et al. Biomarker panel diagnosis of thyroid cancer:a critical review[J]. Expert Rev Anticancer Ther, 2008, 8(9):1399-1413.
  18. 18. Fischer S, Asa SL. Application of immunohistochemistry to thyroid neoplasms[J]. Arch Pathol Lab Med, 2008, 132(3):359-372.
  19. 19. Prasad ML, Pellegata NS, Huang Y, et al. Galectin-3, fibronectin-1,CITED-1, HBME1 and cytokeratin-19 immunohistochemistry is useful for the differential diagnosis of thyroid tumors[J]. Mod Pathol, 2005, 18(1):48-57.
  20. 20. 姜軍, 韓曉蓉. 甲狀腺癌的分子生物學研究進展[J]. 中國普外基礎(chǔ)與臨床雜志, 2000, 7(5):326-327.
  21. 21. 王雅輝, 葉暉, 王南鵬, 等. 抑癌基因TIP30在甲狀腺乳頭狀癌中的表達與臨床意義[J]. 中國普外基礎(chǔ)與臨床雜志, 2009, 16(5):356-359.
  22. 22. Ito T, Seyama T, Mizuno T, et al. Unique association of p53 mutations with undifferentiated but not with differentiated carcinomas of the thyroid gland[J]. Cancer Res, 1992, 52(5):1369-1371.
  23. 23. 高榮君, 王南鵬, 葉暉, 等. KiSS-1在甲狀腺乳頭狀癌中的表達及其臨床意義[J]. 中國普外基礎(chǔ)與臨床雜志, 2010, 17(8):775-779.
  24. 24. Asa SL. The role of immunohistochemical markers in the diagnosis of follicular-patterned lesions of the thyroid[J]. Endocr Pathol, 2005, 16(4):295-309.
  25. 25. Fischer AH, Bond JA, Taysavang P, et al. Papillary thyroid carcinoma oncogene (RET/PTC) alters the nuclear envelope and chromatin structure[J]. Am J Pathol, 1998, 153(5):1443-1450.
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