CAJ | 학술논문

目的：探讨肺类癌与甲状腺滤泡癌肺转移的鉴别诊断要点，提高二者诊断的准确性。方法采用光学显微镜对15例肺类癌及15例甲状腺滤泡癌肺转移进行形态学观察，并采用免疫组化方法检测肺类癌及甲状腺滤泡癌肺转移组织中甲状腺转录因子（thyroid transcription factor ， TTF）-1、甲状腺球蛋白（thyroglobulin ，TG）、突触素（synaptophysin ，SY）、血浆嗜铬粒蛋白 A（plasma chromogranin A ，CgA）、神经元特异性烯醇化酶（neuron-specific enolase ，NSE）的表达情况。结果光学显微镜观察结果显示肺类癌与甲状腺滤泡癌肺转移具有相似的形态学特点。免疫组化染色结果显示，TTF-1、SY、CgA及NSE在肺类癌及甲状腺滤泡癌肺转移组织中均有一定程度的阳性表达，SY、CgA及NSE在肺类癌中的阳性表达率显著高于甲状腺滤泡癌肺转移（P＜0．05）；TG在甲状腺滤泡癌肺转移组织呈一致的阳性表达，在肺类癌组织中呈一致的阴性表达。结论 TG可用于肺类癌与甲状腺滤泡癌肺转移的鉴别诊断，而SY、CgA及NSE可作为肺类癌与甲状腺滤泡癌肺转移鉴别诊断的重要辅助诊断指标。
목적：탐토폐유암여갑상선려포암폐전이적감별진단요점，제고이자진단적준학성。방법채용광학현미경대15례폐유암급15례갑상선려포암폐전이진행형태학관찰，병채용면역조화방법검측폐유암급갑상선려포암폐전이조직중갑상선전록인자（thyroid transcription factor ， TTF）-1、갑상선구단백（thyroglobulin ，TG）、돌촉소（synaptophysin ，SY）、혈장기락립단백 A（plasma chromogranin A ，CgA）、신경원특이성희순화매（neuron-specific enolase ，NSE）적표체정황。결과광학현미경관찰결과현시폐유암여갑상선려포암폐전이구유상사적형태학특점。면역조화염색결과현시，TTF-1、SY、CgA급NSE재폐유암급갑상선려포암폐전이조직중균유일정정도적양성표체，SY、CgA급NSE재폐유암중적양성표체솔현저고우갑상선려포암폐전이（P＜0．05）；TG재갑상선려포암폐전이조직정일치적양성표체，재폐유암조직중정일치적음성표체。결론 TG가용우폐유암여갑상선려포암폐전이적감별진단，이SY、CgA급NSE가작위폐유암여갑상선려포암폐전이감별진단적중요보조진단지표。
Objective To explore the main points of identifies diagnosis between pulmonary carci-noid and thyroid follicular carcinoma with lung metastasis ,to improve the accuracy diagnosis of the two diseases .Methods 15 cases of pulmonary carcinoid and 15 cases of thyroid follicular carcinoma with lung metastasis were observed by optical microscope ,and the expression of thyroid transcription factor (TTF)-1 ,thyroglobulin (TG) ,synaptophysin (SY) ,plasma chromogranin A(CgA) ,neuron specific enolase enzyme (NSE) in pulmonary carcinoid and thyroid follicular carcinoma with lung me-tastasis tissue were detected by immunohistochemistry .Results Optical microscope showed that pulmo-nary carcinoid and thyroid follicular carcinoma with lung metastasis had similar morphological charac-teristics .Immunohistochemistry showed that the expression of TTF-1 ,SY ,CgA and NSE in pulmo-nary carcinoid tissue were higher than that of thyroid follicular carcinoma with lung metastasis (P<0 .05) .The expression of TG in thyroid follicular carcinoma with lung metastasis tissue was consist-ently positive ,but in pulmonary carcinoid tissue was consistently negative expression .Conclusion TG can be used in the identify diagnosis of pulmonary carcinoid and thyroid follicular carcinoma with lung metastasis ,and SY ,CgA and NSE can be used as important auxiliary diagnosis index in the identify diagnosis of pulmonary carcinoid and thyroid follicular carcinoma with lung metastasis .