摘要
目的:探讨细胞角蛋白19(CK19)、甲状腺过氧化物酶(TPO)在甲状腺细针穿刺(FNA) BethesdaⅢ类结节组织中的表达情况及临床意义。方法:对156例细胞学为BethesdaⅢ类且有组织病理学诊断的甲状腺FNA标本进行沉渣包埋切片,采用En Vision法检测CK19及TPO在沉渣包埋切片中的表达情况。结果:术后组织病理学确诊为甲状腺乳头状癌(papillary thyroid carcinoma,PTC) 95例,良性病变61例,包括结节性甲状腺肿(nodular goiter,NG) 33例,滤泡性腺瘤(follicular adenoma,FA) 24例,淋巴细胞甲状腺炎(lymphocytic thyroiditis,LT) 4例。免疫细胞化学检测CK19在PTC中明显高表达,阳性表达率为98. 95%,敏感度为98. 95%,特异度为85. 25%; TPO在PTC中明显阴性表达,阴性表达率为93. 68%,敏感度为93. 68%,特异度为96. 72%;两种抗体在PTC中联合表达的阳性率为98. 95%,敏感度为98. 95%,特异度为100. 00%。PTC中CK19阳性表达率及TPO阴性表达率显著高于良性病变(P <0. 01),两种抗体联合表达率在PTC与良性病变间的差异具有统计学意义(P <0. 01)。结论:CK19和TPO联合检测有助于甲状腺FNA BethesdaⅢ类结节组织中PTC与良性病变的鉴别诊断。
Objective: To explore the expression and clinical significance of detecting CK19 and TPO in BethesdaⅢ of thyroid fine needle aspiration( FNA). Methods: 156 cases of thyroid FNA specimens with cytology of BethesdaⅢ and histopathological diagnosis were carried out of sediment embedding slice,and the expression of CK19 and TPO were detected by the method of En Vision in the ediment embedding slice. Results: 95 cases were diagnosed with papillary thyroid carcinoma( PTC) by postoperative histopathology,and 61 cases were benign lesion,including 33 cases of nodular goiter( NG),24 cases of follicular adenoma( FA) and 4 cases of lymphocytic thyroiditis( LT). Immunocytochemistry detection showed that CK19 was highly expressed in PTC,with a positive rate of 98. 95%,and the sensitivity and specificity were 98. 95% and 85. 25% respectively. TPO was negatively expressed in PTC,with a negative expression rate of 93. 68%,and the sensitivity and specificity were 93. 68% and 96. 72% respectively. The two antibodies were combined expressed in PTC with a positive rate of 9 8. 9 5 %,and the sensitivity and specificity were98. 95% and 100. 00% respectively. The positive expression rate of CK19 and negative expression rate of TPO were significantly higher in PTC than benign lesion( P < 0. 01). The combined expression of this two antibodie was statistically different between PTC and benign lesion( P < 0. 01). Conclusion: The combined detection of CK19 and TPO is more helpful for the differential diagnosis of PTC and benign lesions in Bethesda Ⅲ of thyroid FNA.
引文
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