CK19和Galectin-3对甲状腺乳头状微小癌早期诊断和治疗的意义

Expression of CK19 and galectin-3 and their early diagnostic and therapeutic significance in papillary microcarcinoma of thyroid

目的分析CK19和Galectin-3在甲状腺乳头状微小癌（PMCT）中的表达状况，了解这两种抗体组合对PMCr的早期诊断及鉴别诊断的临床价值，并探讨临床手术术式的选择及预后。方法采用免疫组化方法检测23例中CK19和Galecfin-3的表达情况，并术后随访2～72个月。结果CK19和Galectin-3在23例PMCT中阳性表达率分别为91．31％和95．66％，23例患者中行患侧甲状腺腺叶或次全切除15例，双侧甲状腺腺叶切除6例，患侧甲状腺全切加峡部加对侧甲状腺次全切除2例；随访观察，除2例失访，其余21例患者均健在无复发或死亡。结论CK19和Galectin-3对PMCT的早期诊断及与甲状腺良性病变的鉴别诊断具有显著作用。PMCT预后较好，对于偶然发现或低危的PMCT可行甲状腺腺叶或甲状腺次全切除术，并保持临床长期随访观察。

Objective To analysize the expression of CK19 and galectin-3 in papillary of thyroid（PMCT） and the usefulness of two antibodies in early diagnosis and differential diagnosis,and then to investigate the treatment means for PMCT and its prognosis. Methods By immunohistoehemical method, the expression of CK19 and galectin-3 was detected in 23 eases of PMCT, the therapeutic management for PMCT was discussed by 2-72 months follow-up data. Results The expression rate of CK19 and galectin-3 in PMCT was 91.31% and 95.66% respectively; lobectomy of one lobe or subtotal thyroidectomy was performed in 15 cases, bilateral lobectomy in 6 eases, total thyroidectomy and isthmectomy and contralateral subtotal thyroidectomy in 2 eases; no recurrence and death was found in 21 eases with follow-up. Conelu^on CK19 and galectin-3 show a significant value in early diagnosis and differential diagnosis for PMCT; the PMCT has a good prognosis, but for incidentally detected and low- risk PMCT, lobectomy of one lobe or subtotal thyroidectomy could achieve fairly good curative effects.