超声引导下穿刺细胞检测Galectin-3和CK19在良、恶性甲状腺滤泡性肿瘤的表达差异

Different expression of Galectin-3 and CK19 in benign and malignant follicular thyroid tumors by ultrasound-guided fine needle aspiration

目的:探讨超声引导下穿刺细胞检测Galectin-3和CK19在良、恶性甲状腺滤泡性肿瘤的表达差异。方法 :选取甲状腺滤泡状癌(FTC)患者34例分为FTC组,甲状腺滤泡性腺瘤(FA)40例分为FA组。检测患者的超声引导下细针穿刺细胞学检查(FNAC)标本和病理组织的Galectin-3、CK19表达,分析两组FNAC标本的Galectin-3、CK19表达情况;以病理组织的Galectin-3和CK19表达情况为标准,分析FNAC标本表达Galectin-3和CK19的敏感性、特异性和准确性。比较Galectin-3、CK19与FTC患者的临床参数资料的关系。结果 :Galectin-3、CK19在FTC组和FA组的表达有显著差异(Galectin-3:Z=-4.478,P=0.000;CK19:Z=-2.307,P=0.021);FNAC标本检测CK19、Galectin-3表达的敏感性、特异性、准确性分别为85.7%、76.3%、81.3%,和84.7%、91.2%、87.5%。Galectin-3的表达在FTC患者的不同性别、年龄、肿瘤直径之间无明显差异(P>0.05);而Galectin-3阳性率在有淋巴结转移(93.3%)和TNMⅢ+Ⅳ分期(100%)的患者比无淋巴结转移(63.2%)和TNMⅠ+Ⅱ分期(66.7%)患者的高,差异有统计学意义(分期:T=4.359,P=0.037;淋巴结转移:T=4.242,P=0.039);CK19的表达在这些临床参数之间均无明显差异(P>0.05)。结论:FTC患者的FNAC标本检测Galectin-3和CK19的表达明显高于FA患者,可为临床工作用鉴别诊断FTC和FA提供一定的协助作用。

Objective： To explore the different expression of Galectin-3 and CK19 in benign and malignant thyroid follicular tumors by ultrasound-guided biopsy. Methods： Thirty-four patients with follicular thyroid carcinoma （FTC） and 40 patients with follicular adenoma （FA） were divided into FTC group and FA group respectively. The expression of Galeetin-3 and CK19 in the specimens of uhrasound-guided fine needle aspiration cytopathology and in the pathological tissue were detected, analyzed and compared. The expression in the pathological tissue was considered as the gold standard, and then the sensitivity, specificity and accuracy of FNAC specimens to determine Galectin-3 and CK19 were analyzed. The relationship between Galectin-3, CK19 and clinical parameters of patients with FTC were also compared. Results： The expression of Galectin-3 and CK19 between FTC group and FA group were significantly different （Galectin-3：Z=-4.478, P=0.000, CK19：Z=-2.307, P= 0.021）. The sensitivity, specificity, and accuracy of Galeetin-3 and CK19 in FNAC specimens were 85.7%, 76.3% and 81.3% plus 84.7%, 91.2% and 87.5%. The Galectin-3 expression showed no significant difference between the gender, age and tumor size in FTC patients（P〉0.05）. The positive rate of Galectin-3 in patients with lymph node metastasis（93.3%） and TNMⅢ＋ Ⅳ （100%） stage were significantly higher than that in patients without lymph node metastasis （63.2%） and TNM Ⅰ ＋ Ⅱ stage （66.7%）. The difference was statistically significant （Stages： T=4.359, P=0.037; lymph node metastasis： T=4.242, P=0.039）. The expression of CK19 had no significant difference between these clinical parameters （P〉0.05）. Conclusion： The expression of Galectin-3 and CK19 in FNAC specimens from FTC patients was significantly higher than that in patients with FA, which could help to differentiate FTC and FA in clinics.