BRAF^(V600E)、CK19、HBME-1和CD56四种抗体联合检测在甲状腺乳头状癌诊断中的应用价值

Application value of the combined detection of BRAF^(V600E),CK19,HBME-1 and CD56 antibodies in the Exploration of the value of the combined detection of four antibodies,BRAF^(V600E),CK19,HBME-1 and CD56,in the diagnosis of papillary thyroid carcinoma

目的检测BRAF^(V600E)、CK19、HBME-1和CD56抗体在甲状腺乳头状癌(PTC)结节和甲状腺良性结节的表达水平,探讨四种免疫标记联合使用的诊断价值。方法选取2021年11月至2022年11月昆山市第一人民医院病理科179例甲状腺手术标本,其中62例结节性甲状腺肿、腺瘤等良性结节为良性组,117例PTC结节为恶性组。采用免疫组织化学法检测BRAF^(V600E)、CK19、HBME-1和CD56抗体表达水平并分析其检测效能。结果恶性组BRAF^(V600E)、CK19、HBME-1、CD56阳性表达率分别为85.47%、100.00%、99.15%、6.84%,良性组的阳性表达率分别为4.84%、41.94%、8.06%、90.32%,差异有统计学意义(P<0.05)。BRAF^(V600E)、CK19、HBME-1、CD56诊断PTC灵敏度分别为85.47%、100.00%、99.15%、93.16%;特异度分别为95.16%、58.06%、91.93%、90.32%;准确性分别为88.83%、85.47%、96.65%、92.18%。四种抗体联合检测的灵敏度、特异度、准确性均为100.00%。四种抗体联合检测与各抗体单独检测比较,差异有统计学意义(P<0.05)。结论BRAF^(V600E)、CK19、HBME-1和CD56是临床鉴别甲状腺良性结节和PTC结节的重要指标,BRAF^(V600E)、CK19、HBME-1异常过表达和CD56表达缺失是临床诊断PTC的可靠标志物。四种抗体联合检测有效提高PTC的诊断准确性。

Objective To determine the expression levels of BRAF^(V600E),CK19,HBME-1 and CD56 antibodies in papillary thyroid carcinoma(PTC)nodules and benign thyroid nodules,and to investigate the diagnostic value of the combined use of the four immunomarkers.Methods A total of 179 thyroid surgical specimens were selected from the Department of Pathology of the First People’s Hospital of Kunshan from November 2021 to November 2022,of which 62 benign nodules such as goitre nodular and adenoma were used as the benign group and 117 PTC nodules were used as the malignant group.The immunohistochemistry method was employed to detect the expression levels of BRAF^(V600E),CK19,HBME-1 and CD56 antibodies and to analyze its detection efficacy.Results The positive expression rates of BRAF^(V600E),CK19,HBME-1 and CD56 were 85.47%,100.00%,99.15%and 6.84%in the malignant group and 4.84%,41.94%,8.06%and 90.32%in the benign group,respectively,with statistically significant differences(P<0.05).The diagnostic sensitivities of BRAF^(V600E),CK19,HBME-1 and CD56 for PTC were 85.47%,100.00%,99.15%and 93.16%respectively.Meanwhile,their specificity in diagnosing PTC was 95.16%,58.06%,91.93%and 90.32%,and their accuracy in diagnosing PTC was 88.83%,85.47%,96.65%and 92.18%,respectively.The sensitivity,specificity and accuracy of the combined detection of the four antibodies was 100.00%.There was a statistically significant difference(P<0.05)between the detection of the four antibodies in combination compared to each antibody alone.Conclusion BRAF^(V600E),CK19,HBME-1 and CD56 are important clinical indicators to differentiate benign thyroid nodules from PTC nodules.The aberrant overexpression of BRAF^(V600E),CK19 and HBME-1 and the absence of CD56 expression are reliable markers for the clinical diagnosis of PTC.The combined detection of the four antibodies is effective in improving the diagnostic accuracy of PTC.