结节性甲状腺肿合并甲状腺癌病理特征分析与免疫组化研究

Pathological characteristics and immunohistochemical study of nodular goiter with thyroid carcinoma

目的探究结节性甲状腺肿合并甲状腺癌病理特征分析与免疫组化,分析结节性甲状腺肿合并癌变结节的细胞角蛋白19(CKl9)、核蛋白Ki-67的表达意义。方法回顾性分析2017年6月至2020年4月本院收治的40例结节性甲状腺肿合并甲状腺癌患者的临床资料,经手术切除病理标本后,进行常规石蜡切片、免疫组化染色、苏木素伊红染色,并采用光镜观察,分析患者病理形态特征、免疫组化表达。结果40例结节性甲状腺肿合并甲状腺癌患者中,滤泡癌6例,癌结节旁存在非典型性增生结节2例,未分化癌1例,甲状腺乳头状癌31例(微小癌15例)。免疫组化结果:典型乳头状癌患者CK19表达强阳性29例(93.55%),表达弱阳性2例(6.45%)。典型乳头状癌患者核蛋白Ki-67表达呈强阳性23例(79.31%),弱阳性6例(20.69%)。结论免疫组化CK19可为临床鉴别诊断结节性甲状腺肿和甲状腺恶性肿瘤提供可靠参考依据,核蛋白Ki-67有助于评估细胞增殖活性。

Objective To explore the pathological characteristics and immunohistochemical study of nodular goiter with thyroid carcinoma,and to analyze the cytokeratin 19(CKl9)and nucleoproteins Ki-67 in nodular goiter with cancerous nodules.Methods The clinical data of 40 patients with nodular goiter complicated with thyroid cancer admitted to our hospital from June 2017 to April 2020 were retrospectively analyzed.After surgical resection of pathological specimens,routine paraffin sections,immunohistochemical staining and hematoxylin-eosin staining were performed,and light microscopy was used to analyze the pathological morphological characteristics and immunohistochemical expression of patients.Results Among the 40 patients with nodular goiter and thyroid cancer,there were 6 cases of follicular carcinoma,2 cases of atypical hyperplasia nodules near the cancer nodules,1 case of undifferentiated carcinoma,31 cases of papillary thyroid carcinoma(15 cases of microcarcinoma).Immunohistochemical results:the expression of CK19 was strongly positive in 29 cases(93.55%)and weakly positive in 2 cases(6.45%).The expression of nucleoproteins Ki-67 was strongly positive in 23 cases(79.31%)and weakly positive in 6 cases(20.69%)in typical papilary carcinoma.Conclusion Immunohistochemical CK19 can provide a reliable reference for clinical differential diagnosis of nodular goiter and thyroid malignant tumor,nucleoproteins Ki-67 is helpful to evaluate cell proliferation activity.