桥本氏甲状腺肿PCNA的表达和DNA倍体分析及其意义

Expression of PCNA and DNA Ploidy Analysis in Hashimoto Thyroiditis

目的探讨可能导致桥本氏甲状腺肿发生恶变的分子病理学基础。方法用ＳＰ微波免疫组化和自动图像分析技术研究桥本氏甲状腺肿中增殖细胞核抗原（ＰＣＮＡ）的表达及ＤＮＡ倍体状况，结果（１）桥本氏甲状腺肿中萎缩的甲状腺滤泡细胞ＰＣＮＡ染色呈阳性。（２）桥本氏甲状腺肿中嗜酸性细胞ＰＣＮＡ染色呈强阳性。（３）甲状腺乳头状癌中５ＣＥＲ＞１０％所占比例为８０％（８／１０），而甲状腺乳头状腺瘤中５ＣＥＲ＞１０％所占比例为３０％（３／１０）（Ｐ＜０．０５）。结论（１）光镜下呈萎缩状态的甲状腺滤泡细胞处于增殖活跃状态；（２）嗜酸性细胞有可能发生癌变；（３）５ＣＥＲ＞１０％可作为甲状腺乳头状癌和甲状腺乳头状腺瘤鉴别诊断的标准之一。

To study the molecular basis of malignant transformation in Hashimoto thyroiditis.Method Expression of PCNA was studied immunohistochemically and DNA ploidy analysis was undertaken by means of image cytometry techniqtie in patients with Hashimoto thyroiditis(30 cases).Results(1) Atrophied thyroid follictilar cells in Hashimoto thyroiditis have positive PCNA staining,(2)The acidophil cells in Hashimoto thyroiditis have positive PCNA staining.(3)80 percent of thyroid papillary carcinoma cases have 5CER>l0%,while only 30 percent of thyroid papillary adenoma cases have 5CER>l0%(P<0.05),Conclusion(l)Atrophied thyroid follicular cells in microscopic examination have strong proliferative activity.This is conflicted with classical pathologic view.(2)The acidophil cells in Hashimoto thyroidtis have tendency of malignat transformation.(3)5CER>10%can distinguish thyroid papillary carcinoma from thyroid papillary adenoma.