HBME-1、Galectin-3和CD44v6在甲状腺滤泡癌与不典型腺瘤中的表达

Expression of HBME-1,Galectin-3 and CD44v6 in Follicular Thyroid Carcinoma and Atypical Adenoma

探讨间皮瘤相关抗体-1(HBME-1)、半乳糖凝集素-3(Galectin-3)及粘附分子CD44v6在甲状腺滤泡癌(Follicular ThyroidCarcinoma,FTC)与不典型腺瘤(Atypical Thyroid Adenoma,ATA)中的表达差异,寻找有助于二者临床病理诊断的肿瘤标记物及探索其部分发病机制,拟解决在甲状腺临床病理中对良、恶性难以确定的滤泡性肿瘤的准确判定及对其预后的预示作用。采用免疫组化SP三步法检测37例FTC及18例ATA中HBME-1、Galectin-3和CD44v6的表达,以10例嗜酸性腺瘤(OncocyticThyroid Adenoma,OTA)、8例普通滤泡性腺瘤(Follicular Thyroid Adenoma,FTA)、7例甲状腺乳头状癌(Papillary ThyroidCarcinoma,PTC)及5例尸检正常甲状腺组织作为对照。结果显示,HBME-1、Galectin-3及CD44v6在FTC中的阳性表达率分别为70.3%、64.9%和62.2%,在ATA中阳性表达率分别为66.7%、61.1%和61.1%,三者在FTC与ATA中的表达差异均无统计学意义(χ2分别为0.074、0.094、0.245,P值分别为0.786、0.759、0.620,P值均>0.05);在10例OTA中的表达均为100%;8例FTA中的表达分别为3/8例、6/8例及4/8例;7例PTC的表达分别为7/7例、6/7例及7/7例;5例正常尸检甲状腺组织均无表达。由此得出结论:HBME-1、Galectin-3和CD44v6对FTC与ATA的临床病理鉴别诊断无统计学意义,但提示三者可能在甲状腺滤泡癌与不典型腺瘤的发病机制及进展过程中起着某种共同作用。由于此3种标记物已被证实在诸多肿瘤的发生、发展过程中起着重要作用,故在实际甲状腺临床病理诊断中对表达此3种标记物的良、恶性难以确定的病例可能提示其恶性程度增高,尽管不足以诊断为癌,但仍应加强随访。有关FTC与ATA的临床病理诊断与鉴别诊断及二者的发病机制尚有待于进一步的探索和研究。

This paper studies the immunohistochemical expressions of HBME-1, Galectin-3 and CD44v6 in Follicular Thyroid Carcinoma （FTC） and Atypical Thyroid Adenoma （ATA）, in order to find out useful markers for their clinicopathological diagnosis and pathogenesis. SP immunohistochemical technique was applied to detect the expressions of HBME-1, Galectin-3 and CD44v6 in 37 FTC and 18 ATA. 10 cases of oncocytic thyroid adenoma （OTA）, 8 cases of general follicular adenoma （FTA）, and 7 cases of papillar thyroid carcinoma （PTC） were considered, together with 5 cases of normal thyroid from autopsy as the control group. Results show that the expressions of HBME-1, Galectin-3 and CD44v6 were 70.3%, 64.9%, 62.2% in FTC, 66.7%,61.1%,61.1% in ATA, respectively. These three markers do not have difference of statistical significance in FTC and ATA （χ^2 and P values were 0.074 and 0.786, 0.094 and 0.759, 0.245 and 0.62, respectively）. In the control group, the expressions of HBME-I, Galectin-3 and CD44v6 were all positive in OTA, 3/8, 6/8, 4/8 in FTA, 7/7, 6/7, 7/7 in PTC and negative in 5 normal thyroid. It is concluded that there is no statistical significance of HBME-1, Galectin-3 and CD44v6 in the diagnosis and differential diagnosis of FTC and ATA, and it should pay more attention to follow up these three markers. More studies are required on the diagnosis and differential diagnosis of FFC and ATA.