免疫组化在鉴别甲状腺乳头状癌与甲状腺良性病变的应用

Application of Immunohistochemical Panel on the Differential Diagnosis of Papillary Thyroid Carcinoma and Benign Papillary Lesions

目的观察甲状腺良性病变和甲状腺乳头状癌进行免疫组化法的临床鉴别诊断价值研究。方法临床选择2019年4月-2020年2月在本院接受诊治的甲状腺良性病变40例为对照组,同期选择甲状腺乳头状癌病人40例为观察组,免疫组化分析两组研究对象的间皮瘤抗原-1(HBNE-1)、细胞角蛋白19(CK19)、半乳糖凝集素(Galectin-2,Gal-3)等分子标记物的阳性表达情况;分析不同病理类型的甲状腺乳头状癌、不同类型的良性甲状腺病变的间皮瘤抗原-1(HBNE-1)、细胞角蛋白19(CK19)、半乳糖凝集素(Galectin-2,Gal-3)等分子标记物的阳性表达情况。结果观察组的间皮瘤抗原-1(HBNE-1)、细胞角蛋白19(CK19)、半乳糖凝集素(Galectin-2,Gal-3)等分子标记物的阳性表达情况显著高于对照组,差异有统计学意义(P<0.05);经典型甲状腺乳头状癌、滤泡型甲状腺乳头状癌、微小型甲状腺乳头状癌的HBNE-1、CK19、Galectin-3阳性表达比较,差异无统计学意义(P>0.05);慢性淋巴细胞性甲状腺炎10例,甲状腺腺瘤6例,结节性甲状腺肿24例的HBNE-1、CK19、Galectin-3阳性表达比较,差异无统计学意义(P>0.05)。结论甲状腺乳头状癌中HBME-1、CK19、Gal-3阳性表达情况显著高于良性病变,免疫组化检测分子标记物有助于甲状腺乳头状癌和甲状腺良性病变的鉴别诊断。

Objective To study the clinical value of immunohistochemical panel on the differential diagnosis of benign papillary lesions and papillary thyroid carcinoma.Methods 40 benign papillary lesions patients treated from April 2019 to February 2020 in our hospital were included in the control group;over the same time period,40 papillary thyroid carcinoma patients were included in the observation group.The immunohistochemical panel was used to analyze the positive expressions of HBNE-1,cytokeratin 19(CK19)and Galectin-2/Gal-3.The positive expressions of HBNE-1,CK19 and Galectin-2/Gal-3 among different pathological types of papillary thyroid carcinoma and benign papillary lesions patients were recorded.Results The positive expressions of HBNE-1,CK19 and Galectin-2/Gal-3 in the observation group were higher than control group,with statistically significant difference(P<0.05);there were no significant differences about the positive expressions of HBNE-1,CK19 and Galectin-3 among typical papillary thyroid carcinoma patients,follicular papillary thyroid carcinoma patients and micro papillary thyroid carcinoma patients(P>0.05);there were no significant differences about the positive expressions of HBNE-1,CK19 and Galectin-3 among chronic lymphocytic thyroiditis patients(10 cases),thyroid adenoma patients(6 cases)and nodular goiter patients(24 cases)(P<0.05).Conclusion HBNE-1,CK19 and Gal-3 positive expressions in papillary thyroid carcinoma patients are significantly higher those of benign papillary lesions patients;thus the immunohistochemical panel can make the differential diagnosis of papillary thyroid carcinoma and benign papillary lesions.