CK19、CK20、CD56联合检测在甲状腺乳头状癌诊断中的应用

Value of combined detection of cytokeratin 19,cytokeratin 20,and adhesion molecule CD56 in the diagnosis of thyroid papillary carcinoma

目的探究细胞角蛋白19 (CK19)、细胞角蛋白20 (CK20)、黏附分子CD56联合检测在甲状腺乳头状癌诊断中的价值,以提高甲状腺乳头状癌的诊断率。方法选取西安市阎良区人民医院2017年1月至2019年1月期间收治的84例甲状腺切除手术患者为研究对象,其中甲状腺乳头状癌42例(甲癌组)及良性乳头状增生42例(良性组)。采用免疫组化SP法检测并比较两组患者的CK19、CK20、CD56表达情况,同时比较单项诊断及联合诊断甲状腺乳头状癌灵敏度、特异度、阳性预测值、阴性预测值以及诊断准确率。结果甲癌组患者的CK20阳性表达率为23.81%,与良性组的9.52%比较差异无统计学意义(P>0.05);甲癌组患者的CK19阳性表达率为100.00%,显著高于良性组的23.81%,CD56阳性表达率为7.14%,显著低于良性组的90.48%,差异均有显著统计学意义(P<0.05);CK19诊断敏感度、特异度、阳性预测值、阴性预测值、诊断准确率分别为56.76%、100.00%、100.00%、23.81%、61.91%,CK20为88.89%、79.17%、76.19%、90.48%、83.33%,CD56为90.70%、92.68%、92.86%、90.48%、91.67%,三项联合诊断为95.46%、100.00%、100.00%、95.24%、97.62%,灵敏度CK19与CK20比较、CK19与CD56比较、CK19与三项联合诊断比较差异均有统计学意义(P<0.05);CK20特异度与联合诊断比较差异有统计学意义(P<0.05),而其余各指标敏感度、特异度比较差异均无统计学意义(P>0.05)。结论 CK19、CK20、CD56联合诊断能够提高甲状腺乳头状癌诊断的准确性,为临床治疗提供依据。

Objective To explore the value of combined detection of cytokeratin 19(CK19), cytokeratin 20(CK20), and adhesion molecule CD56 in the diagnosis of papilla thyroid carcinoma in order to improve the diagnostic rate of papilla thyroid carcinoma. Methods From January 2017 to January 2019, 84 patients undergoing thyroidectomy in Yanliang District People’s Hospital of Xi’an City were selected as subjects, including 42 patients of thyroid papilla carcinoma(thyroid carcinoma group) and 42 patients of benign papillary hyperplasia(benign group). The expression of CK19, CK20, and CD56 in the two groups was detected and compared by immunohistochemical SP method, and the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of single diagnosis and combined diagnosis of papilla thyroid carcinoma were compared. Results The positive expression rate of CK20 in thyroid carcinoma group was 23.81%, which had no significant difference compared with 9.52% in benign group(P>0.05);the positive expression rate of CK19 in thyroid carcinoma group was 100.00%, significantly higher than 23.81% in benign group;the positive expression rate of CD56 was 7.14%, significantly lower than 90.48% in benign group. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 56.76%,100.00%, 100.00%, 23.81%, 61.91% for CK19, 88.89%, 79.17%, 76.19%, 90.48%, 83.33% for CK20, 90.70%, 92.68%,92.86%, 90.48%, 91.67% for CD56, and 95.46%, 100.00%, 100.00%, 95.24%, 97.62% for combined detection. There were significant differences in the sensitivity between CK19 and CK20, CK19 and CD56, CK19 and combined detection(P<0.05). The specificity showed statistically significant difference between CK20 and combined detection(P<0.05), and sensitivity and specificity had no statistically significant difference between other indicators(P>0.05). Conclusion The combined detection of CK19, CK20, and CD56 can improve the accuracy of the diagnosis of papillary thyroid carcinoma and provide the basis for clinical treatment.