胸腺上皮性肿瘤中TTF1、Ki-67的表达与WHO分型的关系及临床意义

Expression and clinical significance of TTF1 and Ki-67 in thymic epithelial tumors associated with World Health Organization classification

目的观察TTF1及Ki-67在胸腺上皮性肿瘤(Thymic epithelial tumors,TET)中的表达情况,探讨其与WHO分型的关系及二者的相关性。方法收集59例TET标本,其中诊断一致的51例,不一致8例。应用免疫组化技术检测TTF1及Ki-67在诊断一致的51例TET及30例胸腺增生组织中的表达情况,并分析其与临床病理参数之间的关系。结果在诊断不一致的8例TET中,4例与AB型有关。在诊断一致的51例TET中,TTTF1及Ki-67在TET中的表达均显著高于胸腺增生组(P<0.05)。TTF1仅在AB型胸腺瘤中表达(11/15),其表达与WHO分型有关。Ki-67标记指数从A型到胸腺癌逐渐增加,且在A型与胸腺癌的表达范围不重叠,其表达与WHO分型及MasaoKa分期均有关。同时TTF1及Ki-67在TET中的表达没有相关性。结论 TTF1是AB型胸腺瘤相对特异性的标记;Ki-67不仅对A型与胸腺癌中的区分有帮助,同时具有很好的指示预后的价值。

Objective To study the role of TTF1 and Ki-67 in thymic epithelial tumors（TET）and their relevance.Methods Fifty-nine cases of TET were collected.The pathologists were agreed on 51 cases,disagreed 8 cases,4 of which were involved with type AB.Immunohistochemistry was used to detect TTF1 and Ki-67 expressions in 51 TET with unanimous diagnosis and 30 thymic hyperplasia tissues.The correlations of TTF1 and Ki-67 expression in TET and clinical pathologic characteristics were statistically analyzed.Results Among the disagreed cases,4 of 8 were involved with type AB.There were significant differences of TTF1 and Ki-67 expressions between hyperplasia tissues and TET.Only 11 of 15 type AB expressed TTF1.The expression of TTF1 had positive correlation with World Health Organization classification（WHO）in TET.Ki-67 labeling index increased from type A to thymic carcinoma and its expression range of type A and thymic carcinoma did not overlap each.Ki-67 labeling index was correlated with WHO and clinical stages in TET.Furthermore,the expression of TTF1 had no correlation with Ki-67 in TET.Conclusion TTF1 is a highly specific marker for type AB.Ki-67 is useful for distinguishing type A from thymic carcinoma and guiding treatment by predictive value.