中国癌症杂志
中國癌癥雜誌
중국암증잡지
CHINA ONCOLOGY
2009年
6期
433-438
,共6页
林军%应亚君%瞿海江%应香岚%文小凤%于乐军
林軍%應亞君%瞿海江%應香嵐%文小鳳%于樂軍
림군%응아군%구해강%응향람%문소봉%우악군
甲状腺%乳头状癌%免疫组化%诊断
甲狀腺%乳頭狀癌%免疫組化%診斷
갑상선%유두상암%면역조화%진단
thyroid%papillary carcinoma%immunohistochemistry%diagnosis
背景与目的:甲状腺乳头状癌的诊断有时会很困难,而淋巴结转移是甲状腺乳头状癌局部复发的主要原因并影响预后.本研究探讨CK19、Galectin-3、HBME-1、p27及CyclinD1在甲状腺乳头状癌中的表达特点和诊断价值以及p27、CyclinD1与乳头状癌淋巴结转移间的关系.方法:收集2005年1月至2008年12月间在我院手术的50例甲状腺良性病变患者 (结节性甲状腺肿40例,甲状腺腺瘤10例)及50例甲状腺乳头状癌(经典型40例,滤泡型10例) 患者的手术标本,用免疫组化EnViSion法检测CK19、HBME-1、Galectin-3、p27及CyclinD1的表达.结果:细胞质或细胞膜均有CK19、Galectin-3和HBME-1三种标志物表达,但p27和CyclinD1则在细胞核表达.CK19、HBME-1、Galectin-3在甲状腺乳头状癌中的表达阳性率分别为100%、96%和100%,而在良性病变中则为10%、10%和6%,两者比较差异有显著性(P<0.01).p27在甲状腺乳头状癌的表达阳性率为14%,而在良性病变中则为84%,两者比较差异有显著性(P<0.01).CyclinD1在甲状腺良、恶性病变中的表达阳性率分别为68%和78%,两者间差异无显著性(P>0.05).在甲状腺乳头状癌患者中,CK19、Galectin-3和HBME-1共同表达者占98%(49/50),其中伴p27低表达者占90%(45/50),而在良性病变者中则分别为2%(1/50)和0%(0/50),前两者与后者之间相比,差异有显著性(P<0.01).p27低表达与CyclinD1表达(转移组阳性率72.7%,未转移组71.4%)与甲状腺乳头状癌淋巴结转移间无显著相关性(P>0.05).结论:联合检测CK19、Galectin-3和HBME-1对甲状腺乳头状癌的诊断与鉴别诊断具有重要价值,而p27的低表达与CyclinD1表达对甲状腺乳头状癌的淋巴结转移无提示作用.
揹景與目的:甲狀腺乳頭狀癌的診斷有時會很睏難,而淋巴結轉移是甲狀腺乳頭狀癌跼部複髮的主要原因併影響預後.本研究探討CK19、Galectin-3、HBME-1、p27及CyclinD1在甲狀腺乳頭狀癌中的錶達特點和診斷價值以及p27、CyclinD1與乳頭狀癌淋巴結轉移間的關繫.方法:收集2005年1月至2008年12月間在我院手術的50例甲狀腺良性病變患者 (結節性甲狀腺腫40例,甲狀腺腺瘤10例)及50例甲狀腺乳頭狀癌(經典型40例,濾泡型10例) 患者的手術標本,用免疫組化EnViSion法檢測CK19、HBME-1、Galectin-3、p27及CyclinD1的錶達.結果:細胞質或細胞膜均有CK19、Galectin-3和HBME-1三種標誌物錶達,但p27和CyclinD1則在細胞覈錶達.CK19、HBME-1、Galectin-3在甲狀腺乳頭狀癌中的錶達暘性率分彆為100%、96%和100%,而在良性病變中則為10%、10%和6%,兩者比較差異有顯著性(P<0.01).p27在甲狀腺乳頭狀癌的錶達暘性率為14%,而在良性病變中則為84%,兩者比較差異有顯著性(P<0.01).CyclinD1在甲狀腺良、噁性病變中的錶達暘性率分彆為68%和78%,兩者間差異無顯著性(P>0.05).在甲狀腺乳頭狀癌患者中,CK19、Galectin-3和HBME-1共同錶達者佔98%(49/50),其中伴p27低錶達者佔90%(45/50),而在良性病變者中則分彆為2%(1/50)和0%(0/50),前兩者與後者之間相比,差異有顯著性(P<0.01).p27低錶達與CyclinD1錶達(轉移組暘性率72.7%,未轉移組71.4%)與甲狀腺乳頭狀癌淋巴結轉移間無顯著相關性(P>0.05).結論:聯閤檢測CK19、Galectin-3和HBME-1對甲狀腺乳頭狀癌的診斷與鑒彆診斷具有重要價值,而p27的低錶達與CyclinD1錶達對甲狀腺乳頭狀癌的淋巴結轉移無提示作用.
배경여목적:갑상선유두상암적진단유시회흔곤난,이림파결전이시갑상선유두상암국부복발적주요원인병영향예후.본연구탐토CK19、Galectin-3、HBME-1、p27급CyclinD1재갑상선유두상암중적표체특점화진단개치이급p27、CyclinD1여유두상암림파결전이간적관계.방법:수집2005년1월지2008년12월간재아원수술적50례갑상선량성병변환자 (결절성갑상선종40례,갑상선선류10례)급50례갑상선유두상암(경전형40례,려포형10례) 환자적수술표본,용면역조화EnViSion법검측CK19、HBME-1、Galectin-3、p27급CyclinD1적표체.결과:세포질혹세포막균유CK19、Galectin-3화HBME-1삼충표지물표체,단p27화CyclinD1칙재세포핵표체.CK19、HBME-1、Galectin-3재갑상선유두상암중적표체양성솔분별위100%、96%화100%,이재량성병변중칙위10%、10%화6%,량자비교차이유현저성(P<0.01).p27재갑상선유두상암적표체양성솔위14%,이재량성병변중칙위84%,량자비교차이유현저성(P<0.01).CyclinD1재갑상선량、악성병변중적표체양성솔분별위68%화78%,량자간차이무현저성(P>0.05).재갑상선유두상암환자중,CK19、Galectin-3화HBME-1공동표체자점98%(49/50),기중반p27저표체자점90%(45/50),이재량성병변자중칙분별위2%(1/50)화0%(0/50),전량자여후자지간상비,차이유현저성(P<0.01).p27저표체여CyclinD1표체(전이조양성솔72.7%,미전이조71.4%)여갑상선유두상암림파결전이간무현저상관성(P>0.05).결론:연합검측CK19、Galectin-3화HBME-1대갑상선유두상암적진단여감별진단구유중요개치,이p27적저표체여CyclinD1표체대갑상선유두상암적림파결전이무제시작용.
Background and purpose: The diagnosis of thyroid papillary carcinoma sometimes is difficult, metastasis of lymph node is the major reason of local relapse and influence prognosis.This study explores the immunohistochemical expression and their diagnostic value of CK19,HBME-1,galectin3,p27 and cyclinD1 in thyroid papillary carcinoma and the relations between p27,cyclinD1 and lymph node metastasis of papillary carcinoma.Methods: Immunohistochemical staining was used on 50 specimens of benign lesions (40 speciments of nodular goiters and 10 cases of follicular adenomas) and 50 specimens of papillary carcinomas (40 specimens of classic variants and 10 specimens of follicular variants) operated in our hospital from January of 2005 to December of 2008. Results: CK19,HBME-1 and galectin3 were expressed in cytoplasm or on the membrane, but p27 and cyclinD1 were expressed on the nucleus. The expressions of CK19,HBME-1 and galectin3 in thyroid papillary carcinoma were middle to strong positive, the positive ratios were 100%,96% and 100%, respectively;their expressions in benign lesions were negative or low positive, the positive ratios were 10%,10% and 6%, respectively;there were statistical differences between them (P<0.01). The expression of p27 in thyroid papillary carcinoma was low positive or negative, the positive ratio was 14%, but the expression of p27 in benign lesions was middle to strong positive, the ratio was 84%, there was also significant difference between them(P<0.01). The expression of CyclinD1 were similar in benign and malignant lesions of thyroid, the positive ratios were 68% and 78%, respectively, there was no statistical difference between them(P>0.05). There were significant differences(P<0.01) between the benign lesions and the papillary carcinomas in terms of the combination of CK19,HBME-1 and galectin3 expression and there were no significant differences(P>0.05) in the group of the former with underexpression of p27 between the two groups. The differences were not statistically significant (P>0.05) between the underexpression of p27 with the expression of cyclinD1 (the positive ratios in metastasis group and no metastasis group are 72.7% and 71.4%) in the lymph node metastasis. Conclusion: The combined immunohistochemical stainings of CK19,HBME-1 and galectin3 are useful on the diagnosis and differential diagnosis of thyroid papillary carcinoma, there is no predicted value of the underexpression of p27 with the expression of cyclinD1 for lymph node matastasis of thyroid papillary carcinoma.
