甲状腺乳头状癌与良性乳头状增生中p16、CD56蛋白表达特点及诊断价值

The expressional characteristics and diagnostic values of p16 and CD56 protein in the papillary thyroid carcinoma and benign papillary hyperplasia

目的探讨p16与CD56标记在甲状腺乳头状癌(papillary thyroid carcinoma,PTC)和良性乳头状增生(benign papillaryhyperplasia,BPH)中的表达特点与诊断价值。方法采用免疫组化EnVision两步法检测46例PTC及22例BPH中p16与CD56蛋白的表达。结果乳头状癌中p16阳性率以(+～)为主,分布呈癌巢中央区阳性率低、浸润性边缘阳性率高的特点,癌周组织(-)。CD56在80%的癌组织中表达缺失,其余病例呈(+～),癌周组织(+)。p16、CD56对PTC和BPH的诊断敏感度为98%、80%;特异度为82%、64%;准确度为93%、75%。两者平行联合检测,敏感度达100%,特异性降为55%,如串联联合,特异性升高为91%,敏感度率为78%。结论 p16蛋白是鉴别PTC与BPH的良好标记物,CD56对这两种病变的诊断价值有限,p16、CD56蛋白联合检测并不优越于p16单独标记。

Purpose To explore the expressional characteristics and differential utilities of p16 and CD56 protein in papillary thyroid carcinoma（PTC） and benign papillary hyperplasia（BPH）.Methods p16 and CD56 expression were detected in 46 cases of PTC and 22 cases of BPH by immunohistochemistry method.Results p16 in PTC showed ＋～ positivity in most cases and displayed the features of dispersed distribution in central region and dense aggregation on the invasive margin,whereas was negative in the neighboring benign tissue.CD56 expression was lost in 80% of cases,while ﹢～ expression was observed in the rest cases.Positive staining of CD56 was present in the neighboring benign tissue.The sensitivity,specialty and accuracy of p16 and CD56 were 98%,82%,93% and 80%,64%,75% respectively.By combination of the two markers with parallel and serial patterns separately,the sensitivity and specialty were 100%,55% and 78%,91% in turn.Conclusions p16 could serve as an auxiliary marker in the differential diagnosis of PTC and BPH;However,CD56 may have a limited effect.The joint efficacy of the two markers seemingly is not more superior to that of p16 alone.