HBME-1、CK19基因在甲状腺结节的表达状态及诊断价值

Studies on the Expressions of HBME-1、CK19 and Their Diagnostic Value in Thyroid Nodule

目的：研究分析HBME-1、CK19基因在甲状腺结节的表达状态及诊断价值。方法：回顾性分析天津肿瘤医院头颈外科1975．1～1998．1月收治的初治甲状腺乳头状癌行甲状腺癌联合根治术的有完整随访资料的93例患者临床、组织病理和免疫组织化学染色资料，与同期收治的15例结节性甲状腺肿、16例甲状腺腺瘤相比较。对常规HE染色证实上述病变的蜡块分别行HBME-1和CK19免疫组织化学染色。结果：93例甲状腺乳头状癌病例中，HBME-1基因阳性表达甲状腺乳头状癌为51例（54．8％），甲状腺良性病变为5例（16．1％）；CK19基因阳性表达甲状腺乳头状癌为39例（41．9％），甲状腺良性病变为4例（12．9％）。两种基因在甲状腺乳头状癌和良性病变中的阳性表达均存在统计学差异。HBME-1、CK19基因表达与甲状腺乳头状癌患者的性别、年龄、肿瘤大小、局部侵犯、颈淋巴结转移无明显相关性。结论：HBME-1、CK19基因在甲状腺乳头状癌中表达增强，在甲状腺结节的鉴别诊断中是有用的辅助手段。CK19在区分甲状腺乳头状癌和乳头状增生中是一个很好的标志物。

Objective： Aberrant expressions of HBME-1, CK19 have been found in thyroid nodule. Therefore, their diagnostic value and the relationship between the expressions have been investigated in the pa- per. Methods.. From January 1975 to January 1998, 124 patients with thyroid masses（93 cases with papillary thyroid carcinoma; 15 eases with nodular goiter and 16 eases with follicular adenoma）who were never treated before were treated surgically in Department of Head＆ neck, Cancer Institute ＆ Hospital Affiliating Tianjin Medical University. Archival tissue specimens of these 124 patients were examined for HBME-1、CK19 expressions by the way of immunohistochemical staining. Results： The rates of immuno-positive staining of HBME- 1,CK19 in papillary thyroid carcinoma were54.8% ,41.9% respectively, which were significantly higher than that of benign lesions （16.1% ,12.9%, respectively ）. No significant relationship was found among the expressions of HBME-1、CK19 and the gender,age,tumor size,local invasion and cervical lymph node metastasis in thyroid papillary carcinoma. Conclusion： The expression levels of HBME-1,CK19 are significantly higher in papillary thyroid carcinoma than that of thyroid benign lesions, which may be of some diagnostic value in clinic. CK19 is a valuable marker in making distinction between papillary carcinoma and papillary hyperplasia.