34βE12、Galectin-3及HBME-1在甲状腺良、恶性结节中的表达差异及临床诊断价值

Expression and diagnostic value of 34βE12,Galectin-3 and HBME-1 in thvroid nodules

目的分析甲状腺良恶性结节中34βE12、Galectin-3及HBME-1的表达状况,并探讨其在鉴别甲状腺乳头状癌(papillary thyroid carcinoma,PTC)与甲状腺良性结节中的临床价值。方法采用免疫组化En Vision TM两步法检测352例患者中34βE12、Galectin-3及HBME-1的表达水平,分析这3个蛋白标记物与PTC临床病理特征的相关性,利用ROC曲线评估其鉴别诊断价值。结果 34βE12、Galectin-3及HBME-1在PTC病灶中的阳性率均显著高于甲状腺良性结节中的表达水平,且这3个蛋白标记物在PTC不同性别、年龄、病灶数目、肿瘤大小、包膜是否突破、有无淋巴结转移以及TNM分期中的表达差异均无统计学意义(P均>0.05)。34βE12、Galectin-3及HBME-1对鉴别PTC与甲状腺良性疾病中的ROC曲线下面积(AUC)分别为0.936、0.915、0.898,灵敏度分别为94.3%、95.5%、91.1%,特异度分别为81.1%、71.7%、83.0%,准确度分别为90.3%、88.4%、88.6%。结论 34βE12、Galectin-3及HBME-1在甲状腺良恶性结节中的表达存在统计学差异,并且与PTC的临床病理特征无关,对鉴别甲状腺良恶性结节的性质具有重要的临床辅助价值。

OBJECTIVE To study the expressions of 34βE12,Galectin-3 and HBME-1 in thyroid nodules,and to explore its diagnostic value for papillary thyroid carcinoma（PTC）.METHODS En Vision-（TM） immunohistochemical technique was used to detect the expression of 34βE12,Galectin-3 and HBME-1 in 352 thyroid lesions.The correlation between the expressions of the 3 protein markers and clinicopathological characteristics was evaluated.The receiver operating characteristic area under the curve（ROC-AUC） and their index for diagnosis evaluation were also calculated.RESULTS The positive rates of 34βE12,Galectin-3 and HBME-1 in 246 PTC lesions were significantly higher than those in benign nodules（P〈0.001）.There was no relationship between the expression of the 3 protein markers and clinicopathological characteristics（eg.gender,age,numbers of lesions,tumor size,capsular invasion,lymph node metastasis,TNM staging）.The ROC-AUC of 34βE12,Galectin-3 and HBME-1 for diagnosis of PTC was 0.936,0.915 and 0.898 respectively.The sensitivity of 34βE12,Galectin-3 and HBME-1 for diagnosis of PTC was 94.3%,95.5%and 91.1%respectively,while the specificity was 81.1%,71.7%and83.0%respectively,and the diagnostic accuracy rate was90.3%,88.4%and 88.6%respectively.CONCLUSION The expressions of 34βE12,Galectin-3 and HBME-1 are statistically different between PTC and benign lesions,but no associations are found with clinicopathological characteristics,indicating the three protein markers have important diagnostic value for PTC.