Cytokeratin-19、Fibronectin-1、HBME-1和Galectin-3在甲状腺微小乳头状癌中的应用价值

Application value of cytokeratin 19, fibronectin1, HBME-1 and galectin-3 in papillary thyroid microcarcinoma

目的 分析甲状腺微小乳头状癌（papillary thyroid micro carcinoma,PTMC）的临床病理学特征,观察CK19、HBME-l、Galectin-3和Fibronectin-1在甲状腺微小乳头状癌和良性甲状腺病变中的表达差异及其在甲状腺良恶性病变鉴别诊断中的意义.方法 回顾性分析我院2006~2011年98例PTMC患者的临床病理学资料,采用免疫组化方法检测半乳凝素-3（Galectin-3）,纤维粘连蛋白- 1（Fibronectin-1）,细胞角蛋白-19（CK19）和HBME 1在98例PTMC及98例甲状腺良性病变（35例乳头状增生、42例结节性甲状腺肿、5例甲状腺腺瘤、11例淋巴细胞性甲状腺炎、5例亚急性甲状腺炎）中的表达情况.结果 98例PTMC患者中,有85例（86.7%）同时出现CK19、HBME-l、Galectin-3、FN1中到强阳性表达,而良性病变（乳头状增生、结节性甲状腺肿、甲状腺腺瘤、淋巴细胞性甲状腺炎、亚急性甲状腺炎）,患者未见同时出现CK19、HBME-l、Galectin-3和FN1中、强阳性表达.结论 CK19、HBME-1、Galectin-3和FN1均呈中、强阳性表达是鉴别甲状腺良恶性病变的重要参考指标.

Objective To analyze the clinicopathologic features of papillary thyroid microcarcinoma （PTMC）, and ob- serve the expression difference of CK19, HBME-1, Galectin-3 and Fibronectin-1 in PTMC and benign thyroid lesions and the meanings in the differential diagnosis of PTMC. Methods The clinical pathological records of 98 cases with PTMC were analyzed retrospectively. The expression of Galectin-3, Fibronectin-1, CK19 and HBME-1 were deter- mined by immunohistochemical method in the 98 cases with PTMC and 98 cases with benign thyroid lesions（including 35 cases of papillary hyperplasia, 42 cases of nodular goiter, 5 cases of thyroid adenoma, 11 cases of lymphocytic thy- roiditis and 5 cases of subacute thyroiditis）. Results In 98 cases with PTMC, 85 cases （86.7%） got the moderate or strong positive expression in the CK19, HBME-1, Galectin-3 and Fibronectinl. While, the moderate or strong positive expression of the CK19, HBME-1, Galectin-3 and Fibronectin-1 did not appear in the benign thyroid lesions （includ- ing papillary hyperplasia, nodular goiter, thyroid adenoma, lymphocytic thyroiditis and subacute thyroiditis）. Conclu- sion It is a significant index to distinguish benign and malignant thyroid lesions that CK19,HBME1,Galectin-3 and Fibronectinl get the moderate or strong positive expression.