细胞角蛋白19、半乳糖凝集素3、甲状腺过氧化物酶和CD56对甲状腺良恶性病变鉴别诊断的价值

Value of cytokeratin 19,galectin-3,thyroid peroxidase and CD56 in differential diagnosis of thyroid benign and malignant lesions

目的探讨细胞角蛋白19(CK19)、半乳糖凝集素3(Galectin-3)、甲状腺过氧化物酶(TPO)和CD56对甲状腺良、恶性病变鉴别诊断的价值。方法应用免疫组化染色检测CK19、Galectin-3、TPO和CD56在92例甲状腺乳头状癌组织(PTC组)和67例甲状腺良性病变组织(良性病变组)中的表达情况。结果 CK19、Galectin-3和TPO阳性表达部位在细胞质内,CD56阳性表达部位在细胞膜和/或细胞质。PTC组CK19和Galectin-3的阳性率均高于良性病变组,而TPO和CD56阳性率均低于良性病变组(P<0.01)。CK19、Galectin-3、TPO和CD56诊断PTC的灵敏度分别为97.8%、76.1%、79.3%和95.7%;特异度分别为56.7%、56.7%、94.0%和67.2%;联合检测2个指标诊断PTC的灵敏度几乎达到100%。结论联合检测CK19、Galectin-3、TPO和CD56可明显提高鉴别诊断甲状腺良、恶性病变的准确性。

Objective To evaluate the value of cytokeratin 19 （CK19）, galectin-3, thyroid peroxidase（TPO） and CD56 in differential diagnosis of papillary thyroid carcinoma（PTC） and benign thyroid lesions. Methods The expressions of CK19, galectin-3,TPO and CD56 in PTC（group A, 92 cases） and benign thyroid lesions（group B,67 cases） were detected by immunohistochemical staining. Results CK19, galectin-3 and TPO were positively expressed in the cytoplasm and CD56 was positively expressed in the cell membrane and/or cytoplasm. The positive rates of CK19 and galectin-3 in group A were higher than those in group B, while the positive rates of TPO and CD56 were lower than those in group B（P〈0. 01）. The sensitivities of CK19, galeetin-3, TPO and CD56 in the diagnosis of PTC were 97.8%,76. 1%,79.3% and 95.7%,and the specificities were 56.7%,56.7%,94. 0% and 67.2%, respectively. When combined detection of two of the four indicators, the sensitivity in the diagnosis of PTC was almost 100%. Conclusion Combined detection of CK19, galectin-3, TPO and CD56 can significantly improve the accuracy of differential diagnosis of thyroid benign and malignant lesions.