高分子量角蛋白和TPO在甲状腺乳头状癌诊断中的价值

The study of the role of high molecular weight keratin and TPO protein in the diagnosis of thyroid papillary carcinoma

目的探讨高分子量角蛋白和TPO蛋白在甲状腺乳头状癌诊断与鉴别诊断中的作用。方法用免疫组化EnVision法测定50例甲状腺乳头状癌及110例甲状腺良性病变(结节性甲状腺肿伴乳头状增生50例、癌旁组织50例和滤泡性腺瘤10例)高分子量角蛋白和TPO表达情况。结果50例甲状腺乳头状癌高分子量角蛋白阳性46例,阴性4例;110例甲状腺良性病变高分子量角蛋白均阴性。50例甲状腺乳头状癌TPO阴性48例,阳性2例;110例甲状腺良性病变TPO均阳性。高分子量角蛋白和TPO在甲状腺乳头状癌诊断中的评价指标:敏感度分别为92%、96%,特异度分别为100%、100%,准确度分别为97.5%、98%,阳性预测值均为100%,阴性预测值分别为96.49%、98.21%。平行试验显示,高分子量角蛋白和TPO联合测定敏感度为99.7%,特异度为100%。结论高分子量角蛋白和TPO蛋白均可作为鉴别甲状腺乳头状癌与结甲伴乳头状增生等良性病变的重要参考标志物,联合测定效果更好。

Objective To study the role of High Molecular Weight keratin and TPO protein in the diagnosis of thyroid papillary, caieinoma.Methods The expression of High Molecular Weight keratin and TPO profien in 50 eases of papillary, thyroid earcinomas and 110 cases of thyroid benign diseases were dectected by inmmunohisterchemistrical EnVision Method. Results Of the 50 cases thyroid papillary carcinomas,46 of them were positive to High Molecular Weight keratin,48 of them were negative to TPO; while all of the 110 eases of thyroid benign diseases were negative to High Moleettlar Weight keratin and positive to TPO. The assessed values of High Moleettlar Weight keratin and TPO in the diagnosis thyroid papillary carcinoma were below： Sen were 92% and 960 ,Spe were 100% and 100%, Ace were97.5% and 98%, ＋PVwere 100% and 100%,and PV were96.49% and98.21%.Conclusion High Molecular Weight keratin and TPO protein are useful markers in the different diagnosis between malignant and benign thyroid papillary hyperplasia.