CK19和CKH在甲状腺病变的表达及诊断价值

The expression and Diagnostic Value of CK19, CKH in Thyroid Lesions

目的研究分析细胞角蛋白（CK）19、高分子量细胞角蛋白（CKH）在甲状腺结节的表达及诊断价值。方法采用免疫组化SP法检测62例甲状腺癌（56例乳头状癌，6例滤泡癌）、12例甲状腺腺瘤，20例结节性甲状腺肿和10例桥本甲状腺炎中CK19和CKH的表达。结果CK19和CKH在甲状腺乳头状癌中的阳性率分别为100％和89.3％，与良性病变中的表达率14．3％和0％差异有统计学意义（P〈0.05）。CK19和CKH在滤泡型乳头状癌与滤泡癌之间进行比较，差异有统计学意义（P〈0．05）。CK19、CKH检测在鉴别甲状腺乳头状癌和良性病变时的敏感性、特异性及诊断正确率分别为100％、89．3％，85.7％、100％，93．8％、87．8％；CK19的敏感性高，而CKH的特异性高。结论CK19和CKH有助于甲状腺乳头状癌与甲状腺良性增生性病变、甲状腺滤泡型乳头状癌与滤泡癌的诊断与鉴别诊断；而且CK19、CKH联合检测有助于提高甲状腺良性病变的诊断正确率。

Objective Aberrant expression of CK19 ,CKH have been found in thyroid lesions. Therefore, their diagnostic value and the relationship between the expression have been investigated in the paper. Methods By immunochemical SP method ,the expression of CK19 and CKH were detected in 62 cases of carcinomas （including 56 papillary carcinomas and 6 follicular carcinomas）, 12 follicular adenomas and 20 multinodular goiters and 10 Hashimoto＇s thyroidities. Results The rats of immuno-positive staining of CK19 and CKH in papillary thyroid carcinoma were 100% and 89.3% ,respectively,which were significantly higher than that of benign lesions. （14.3% and 0%,respectively）. The expression of the CK19 and CKH in follicular variant of papillary carcinoma both differed significantly form that in the follicular sdenomas （P〈0.05）. The sensibility ,specificity and positive predictive value rate of using CK19 and CKH in differentiation benign from papillary thyroid carcinoma were 100%, 89.3%, 85.7% ,100% ,93.8% ,87.8% ,respectively. CK19 has more higher sensitivity; the specificity of CKH was more higher. Conclusion The results of this study show that immunohistochemical of CK19 ,CKH was uesful for diagnosis and differential diagnosis in thyroid papillary carcionma with benign lesions, combination of CK19,CKH can improve the rate of correct diagnosis in thyroid lessions.