桥本甲状腺炎不典型细胞群Galectin-3、CK19、CK7的表达及意义

Expression and its significance of galectin-3,cytokeratin 19 and cytokeratin 7 in atypical thyrocytes of Hashimoto′s thyroiditis significance

目的探讨桥本甲状腺炎(Hashimoto′s thyroiditis,HT)中不典型细胞群与甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的关系及其临床病理意义。方法从存档病例中选取45例PTC和40例HT,以40例腺瘤周围甲状腺组织为对照,进行常规形态学观察和Gal-3、CK19和CK7、MaxVision法免疫组化染色,以χ2检验分析表达结果。结果(1)HT增生的淋巴滤泡周围可见到PTC-核样改变的不典型细胞群;(2)Gal-3在PTC,HT不典型细胞群及对照组表达率分别为89%,10%,0,差异有统计学意义(P<0.05),前组高于后两组,后两组间差异无统计学意义(P>0.05);(3)CK19和CK7在PTC,HT不典型细胞群及对照组的阳性表达率分别为100%,95%,10%和95%,92.5%,12.5%,两种抗体的阳性率和表达部位均较接近,前两组均高于对照组(P<0.05),PTC和HT两组间差异无统计学意义(P>0.05)。结论Gal-3在HT不典型细胞群和PTC组表达的差异性可协助诊断HT是否合并PTC;CK19和CK7在HT不典型细胞群中与PTC组有类似的表达模式,提示HT不典型细胞群可能是PTC的前驱病变,应密切随访,谨防癌变。

Purpose To study the immunohistochemical features of the atypical thyrocytes in Hashimoto＇s thyroiditis （HT） and their pathological significance. Methods 45 PTC cases and 40 HT cases were collected from archive. Another 40 cases of para - adenoma thyroid tissue were set as control. Routine morphological observation was made and immunohistochemical staining for galectin-3 （ Gal- 3）, cytokeratin 19（CK19） and cytokeratin 7 （CK7） was performed by MaxVision technique. Chi-square test was applied. Results （ 1 ） The atypical thyrocytes in HT showing PTC-like nuclear alterations were located around the lymphoid follicles. （2） The positive frequency for Gal-3 of PTC, HT atypical thyrocytes and control was 89% , 10% and 0 respectively. There is significant difference（ P 〈 0. 05 ）between PTC and the other two groups, while the other two groups showed no significant difference（ P 〉 0. 05 ）. （3） The expression pattern for CK19 and CK7 was similar. The positive frequency for CK19 and CK7 of PTC ,HT atypical thyrocytes and control was 100% ,95% ,10% and 95% ,92. 5%, 12. 5% successively. The positive frequency of both PTC and HT atypical thyrocytes group was higher than that of control（ P 〈0.05 ） ,meanwhile, there is no significant difference between PTC and HT atypical thyrocytes. Conclusions Gal-3 was helpful to distinguish PTC foci from the afypical thyrocytes in HT. The similar staining pattern for CK19 and CK7 of PTC and HT atypical thyrocytes suggested that HT atypical thyrocytes may be a precursor lesion of PTC. They should be closely observed for fear of malignant transformation.