甲状腺过氧化物酶在细针抽吸甲状腺肿瘤细胞中的表达及意义

Thyroperoxidase expression in fine needle aspirated thyroid tumor cells and it clinical relevance

目的观察甲状腺过氧化物酶(TPO)在细针抽吸甲状腺肿瘤细胞中的表达,评价TPO免疫化学染色对良、恶性甲状腺肿瘤的鉴别诊断价值。方法应用免疫化学染色法观察TPO在71例手术切除的甲状腺肿瘤组织细针抽吸物(FNA)涂片及组织冰冻切片中的表达,阳性判定按照80%以上甲状腺细胞染色为阳性。结果TPO在恶性组织的FNA细胞涂片与组织切片标本中的表达均低于良性甲状腺肿瘤,差异有统计学意义(P<0.01);而FNA细胞涂片与组织切片TPO表达阳性率无显著差异。图像分析结果显示恶性甲状腺肿瘤细胞的TPO染色强度明显低于良性甲状腺组织细胞,两者平均密度值、相对光密度值和着色的颜色强度均有显著差异(P均<0.05);而FNA细胞涂片和组织切片间无显著差异。甲状腺肿物囊液涂片中良、恶性细胞的TPO表达阳性比分别为20/22、0/4,两者有显著差异(P<0.05)。以H-E染色为参考,FNA细胞涂片阳性及阴性预告值分别为95.74%、91.67%,组织切片染色为100%、66.47%,囊液涂片染色为97.44%、88.46%。结论TPO在良性甲状腺细胞中的表达明显高于恶性甲状腺肿瘤细胞;TPO免疫化学染色可用于甲状腺针吸细胞,作为诊断甲状腺良、恶性肿瘤的辅助手段。

Objective：To observe thyroperoxidase （TPO） expression in fine needle aspirated thyroid tumor cells and to assess the value of TPO immunostaining in differential diagnosis of benign and malignant thyroid tumors. Methods： Fine needle aspiration （FNA） samples and frozen tissue sections of 71 surgically resected thyroid tumor specimens were immunostained by with hTPO MoAb47. The staining results were considered positive if 80% or more thyroid cells were positively stained. Resuits.. TPO expression levels in FNA samples and frozen tissue sections of malignant tumors were lower than those of benign tumors （P〈0.01）, and there was no difference in the results of FNA and frozen tissue sections. We also found that the TPO staining intensity of malignant tumors was markedly lower than that of benign tumors, with significant differences found between the mean densities, relative optic densities, and the intensities of staining color （all P〈0.05）, but with no significant difference found between the results of FNA samples and frozen tissue sections. TPO staining was positive in 20 of the 22 smears of the benign eystoma and in none of the 4 smears of malignant eystoid lesion （P〈0. 05）. Taking the results of H-E staining as the control, the sensitivity of FNA samples was 95.74% and the specificity was 91.67% ; of frozen tissue section were 100% and 66.47% ; and of the eystoid lesions smears were 97.44% and 88.46%, respectively. Conclusion： TPO expression level is obviously higher in benign thyroid tumors than those in the malignant ones. FNA samples can be used for TPO immunoeytoehemistry staining as an adjuvant tool for distinguishing benign and malignant tumors.