甲状腺微小乳头状癌冷冻切片诊断和免疫组化表达及意义

Freezing microtome section diagnosis and immunohistochemical expression of papillary thyroid microcarcinoma and its significance

目的探讨结节性甲状腺肿合并甲状腺微小乳头状癌的冷冻切片诊断及半乳糖凝集素-3(Galectin-3)、间皮瘤相关抗体-1(HBME-1)、细胞角蛋白19(CK19)、CD56的表达及意义。方法对40例冷冻切片诊断为甲状腺微小乳头状癌进行光镜观察并采用免疫组化En Vision法检测Galectin-3、HBME-1、CK19、CD56的表达水平。结果 40例均为甲状腺微小乳头状癌,光镜下主要组织学特征为毛玻璃样核、核沟、纤维性间质、核内包涵体及砂砾体。免疫组化Galectin-3、HBME-1、CK19在甲状腺微小乳头状癌中均呈阳性表达,在结节性甲状腺肿中呈阴性或个别弱阳性表达。CD56在甲状腺微小乳头状癌6例呈轻度着色,34例呈阴性表达,在周围结节性甲状腺肿组织均呈阳性表达。结论甲状腺微小乳头状癌的诊断主要依据组织病理学,Galectin-3、HBME-1、CK19及CD56的联合检测有助于提高甲状腺微小乳头状癌的诊断准确率。

Objective To explore the freezing microtome section diagnosis of nodular goiter complicated with papillary thyroid microcareinoma and the expression and significance of Galeetin-3, human bone marrow endothelial cell-1 （HBME-1）, cytokeratinl9 （CK19） and CD56. Methods A total of 40 diagnosed cases as papillary thyroid microeareinoma by freezing mierotome section were observed by light microscope, and the levels of Galeetin-3, HBME-1, CK19 and CDs6 were detected by immunohistoehemieal EnVision method. Results All the cases were papillary thyroid microeareinoma. Under the light microscope, the main histopathologic features were ground glasslike nuclear, groove, fibrous stromal reactions, nuclear pseudoinclusion and psammoma bodies. The positive staining for Galectin-3, HBME-1 and CK19 was observed in nodular goiter mierocarcinoma, but they were negative or mild expression in nodular goiter. There were 6 cases with papillary thyroid microcarcinoma showing mild staining for CD56 and 34 cases revealed negative expression. In the nodular goiter, all cases showed positive straining. Conclusion Diagnosis of papillary thyroid microcarcinoma is mainly based on tissue pathology. The combined detection of Galectin-3, HBME-1, CK19 and CD56 will improve the accuracy of diagnosing papillary thyroid microcarcinoma.