细胞增殖抗原-67、细胞角蛋白19、人类骨髓内皮细胞、神经细胞黏附分子56和半乳糖凝素-3蛋白表达在甲状腺乳头状癌不同亚型中的诊断价值

Diagnostic value of cell proliferation antigen-67,cytokeratin 19,human bone marrow endothelial cells,neuronal adhesion molecule 56 and galactagglutinin-3 protein expression in different subtypes of papillary thyroid carcinoma

目的比较不同组织学亚型甲状腺乳头状癌(PTC)患者的临床病理特征,探讨细胞增殖抗原-67(Ki-67)、细胞角蛋白19(CK19)、人类骨髓内皮细胞(HBME-1)、神经细胞黏附分子56(CD56)和半乳糖凝素-3(Galectin-3)的表达率。方法收集新疆医科大学附属肿瘤医院2015年6月至2016年6月经病理科诊断为PTC患者的临床病理资料。对302例PTC患者进行免疫组织化学分析,采用例数(构成比)描述不同类型的PTC患者的临床病理特征分布及Ki-67、CK19、HBME-1、CD56和Galectin-3的表达,采用χ^2检验或Fisher精确检验比较其差异性。结果经典PTC与滤泡性乳头状癌的中央区淋巴结转移率(χ^2=6.751,P<0.05)、T分期差异有统计学意义(χ^2=13.568,P<0.05);经典PTC与乳头状微癌的肿瘤直径(χ^2=39.012,P<0.05)、颈部淋巴结转移率(χ^2=15.658,P<0.05)、T分期差异有统计学意义(χ^2=34.173,P<0.05);滤泡性乳头状癌与乳头状微癌的肿瘤直径(χ^2=19.197,P<0.05)、颈部淋巴结转移率(χ^2=7.076,P<0.01)、T分期差异有统计学意义(χ^2=10.980,P<0.05)。经典型PTC患者中,Ki-67、CK19、CD56和Galectin-3的表达率分别为3.8%、100.0%、33.7%和96.2%。滤泡型乳头状癌患者中,Ki-67、CK19、CD56和Galectin-3表达率分别为2.0%、99.0%、29.7%和95.0%。甲状腺微小乳头状癌患者中Ki-67、CK19、CD56和Galectin-3的表达率分别为0.0%、97.8%、33.7%和93.5%。HBME-1在不同组织学亚型的PTC患者肿瘤组织中的表达差异有统计学意义(χ^2=11.716,P<0.05)。进一步比较不同组织学分型的HBME-1发现,经典PTC、滤泡性乳头状癌及乳头状微癌与其他乳头状癌差异有统计学意义(依次为χ^2=10.181、9.901、7.313,P<0.05)。结论在PTC患者的诊断中,联合应用Ki-67、CK19、HBME-1、CD56和Galectin-3将有助于新疆地区PTC的诊断。

Objective Comparing the clinicopathological features of patients with different histological subtypes of papillary thyroid carcinoma(PTC),the expression rates of cell proliferation antigen-67(Ki-67),cytokeratin 19(CK19),human bone marrow endothelial cells(HBME-1),neuronal adhesion molecule 56(CD56)and galactagglutinin-3(Galectin-3)were also investigated.Methods The clinicopathological data of patients with PTC were collected from June 2015 to June 2016 in the affiliated Cancer Hospital of Xinjiang Medical University.In 302 cases of PTC The number of cases(composition ratio)was used to describe the distribution of clinicopathological features and the expression of Ki-67,CK19,HBME-1,CD56 and Galectin-3 in patients with different types of PTC.The differences were compared by chi-square test or Fisher accurate test.Results There were significant differences in lymph node metastasis rate(χ^2=6.751,P<0.05)and T stage(χ^2=13.568,P<0.05)between PTC and follicular papillary carcinoma cervical lymph node metastasis rate(χ^2=15.658,P<0.05),central lymph node metastasis rate(χ^2=5.270,P<0.05),T staging(χ^2=34.173,P<0.05),the difference was statistically significant;Cervical lymph node metastasis rate(χ^2=7.076,P<0.05),T staging(χ^2=10.980,P<0.05),the difference was statistically significant.In patients with typical PTC,Ki-67,CK19,CD56 and Galectin-3 tables the achievement rates were 3.8%,100.0%,33.7%and 96.2%,respectively.Ki-67,CK19,CD56 and Galectin-3 expression rates were 2.0%,99.0%,29.7%and 95.0%in follicular papillary carcinoma patients.The expression rates of Ki-67,CK19,CD56 and Galectin-3 were 0.0%,97.8%,33.7%and 93.5%in patients with thyroid micro papillary carcinoma.HBME-1 expression was statistically significant in tumor tissues of thyroid papillary carcinoma patients with different histological subtypes(χ^2=11.7,P<0.05).Conclusion In the diagnostic of PTC combined application of the above tumor markers may be helpful in the diagnosis of different subtypes of PTC in Xinjiang region of China.