ELISA法检测血清CK-19在甲状腺乳头状癌鉴别诊断中的应用

目的检测细胞角蛋白（cytokeratin，CK-19）在甲状腺乳头状癌（PTC）和结节性甲状腺肿患者血清中的表达，筛选甲状腺乳头状癌的辅助诊断指标。方法采用酶联免疫吸附试验（E1。1SA）法，检测结节性甲状腺肿30例，乳头状癌30例，正常人30例中CK-19的表达。结果（1）CK-19表达水平以甲状腺乳头状癌高[（27．48±6．91）ng／ml]，结节性甲状腺肿居中[（9．75±3．58）ng／ml]，正常人低[（6．54±2．32）ng／ml]，三者差异有统计学意义（F=18．254，P〈0．05）。（2）以16ng／ml为界值，CK-19在结节性甲状腺肿与甲状腺乳头状癌患者血清中的表达率，两者差异有统计学意义（0=53．571，P〈0．05）；此外，以10ng／ml为界值，CK-19在结节性甲状腺肿患者与正常人血清中的表达率，两者差异也有统计学意义（χ2=15．429，P〈0．05）。（3）CK-19表达水平在甲状腺乳头状癌伴淋巴结转移[（32．2±4．63）ng／ml]比未伴淋巴结转移者[（18．93±3．25）ng／ml]更高，两者差异有统计学意义（t=25．648，P〈0．05）。结论甲状腺乳头状癌患者外周血中CK-19表达率增高；CK-19对于甲状腺乳头状癌伴淋巴结转移的诊断具有一定的指导作用。

Objective To explore the value of detecting the expression of cytokeratin （eytokeratin, CK - 19） for thyroid papillary carcinoma（PTC） diagnosis. Methods By Enzyme -linked immunosorbent assay （ELISA） method, 30 cases of nodular goiter, 30 cases of papillary carcinoma, 30 cases of normal people were detected for CK - 19 expression. Results （ 1 ） CK - 19 expression level was high in papillary thyroid carcinoma（27.48 ± 6.91 ng/ml） , middle in nodular goiter （9. 75 ± 3.58ng/ml） , and low in normal（6. 54 ± 2.32 ng/ml）. There is a significant difference of all. （ F = 18. 254, P 〈 0. 05 ） ; （2）To 16 ng / ml for the cutoff value, there was a significant difference （χ2 = 53.571,P 〈 0.05 ） of CK - 19 expression rate in nodular goiter and papillary thyroid carcinoma patients;Furthermore, when taking 10 ng / ml for the cutoff value, there was a significant difference too（ χ2 = 15. 429, P 〈 0.05 ） of CK - 19 expression rate in nodular goiter patients and normal persons ; （ 3 ） CK - 19 expression level in papillary thyroid carcinoma with lymph node metastasis （32.2 ± 4. 63ng/ml） was higher than in those without lymph node metastasis （18.93 ± 3.25ng/ml）. The difference was a significant （ t = 25. 648, P 〈 0. 05 ）. Conclusions CK - 19 expression is increased in patients with papillary thyroid carcinoma; CK - 19 plays a guiding role in diagnosis of papillary thyroid carcinoma with lymph node metastasis.