CK19、Ret/PTC在桥本恶变中的表达及其意义

Expression and Significance of CK19 and Ret/PTC in Hashimoto's Thyroiditis with Thyroid Cancer

目的 :从免疫组织化学角度初步探讨桥本甲状腺炎恶变的发生、发展以及演进的可能机制 ,寻找敏感而又特异的检测指标 ,以助于桥本甲状腺炎恶变的诊断。方法 :采用免疫组化S -P法检测 2 0例甲状腺瘤旁的正常甲状腺组织 ,2 5例桥本甲状腺炎组织以及 2 1例桥本甲状腺炎恶变的标本中CK19、Ret/PTC的表达和分布情况。结果 :CK19、Ret/PTC蛋白在癌旁正常甲状腺组织中无阳性表达 ,而在桥本甲状腺炎以及桥本甲状腺炎合并甲状腺癌组织中均有不同程度的表达 ,两组之间比较 ,CK19、Ret/PTC蛋白阳性表达率差别均无显著性 (P >0 .0 5 )。但其染色形态及强度存在明显差异 (P <0 .0 5 )。CK19、Ret/PTC在桥本甲状腺炎组织中均表现为弱灶性染色。而在桥本甲状腺炎合并甲状腺癌组织中CK19、Ret/PTC多表现为强而弥漫性染色。Ret/PTC的异常表达与乳头状甲状腺癌的淋巴结转移有关 (P <0 .0 5 )。结论 :检测CK19、Ret/PTC的表达 ,有助于桥本甲状腺炎恶变倾向的判断和甲状腺癌的早期诊断 ,Ret/PTC的异常表达对乳头状甲状腺癌的发生、发展。

Objective: To compare the difference of immunohistochemical results between Hashimoto's thyroiditis(HT) and HT with thyroid cancer, select some helpful index to diagnose HT with thyroid cancer. Methods:Immunohistochemical S-P methods was used to examine expression of CK19,Ret/PTC in 25 HT patients, 21 HT with thyroid cancer patients and 20 normal thyroid tissues nearby thyroid follicular adenomas Results: CK19, Ret/PTC had no expression in normal thyroid tissues nearby thyroid follicular adenomas. The positive expression of CK19, Ret/PTC indicated no difference between HT and HT with thyroid cancer (P>0.05). But their immunologic reactive pattern showed evidently difference (P<0.05). CK19, Ret/PTC were all focally stained in HT tissues; and diffuse position was characteristic of HT with thyroid cancer. Abnormal expression of Ret/PTC was correlated with the lymph node metastasis (P<0.05). Conclusions: Ret/PTC protein assay combined with CK19 are useful in early diagnosis, the pathogenesis, lymph node metastasis and prognosis evaluation in Hashimoto's thyroiditis with thyroid cancer.