恶性潜能未定的高分化甲状腺肿瘤中CK19、Galectin-3、HBME-1和TPO的表达及意义

目的 探讨细胞角蛋白19(cytokeratin 19,CK19)、Galectin-3、Hector Battifora mesothelial cell-1(HBME-1)和甲状腺过氧化物酶(thyroid peroxidase,TPO)在恶性潜能未定的高分化甲状腺肿瘤(well-differentiated thyroid tumors of uncertain malignant potential,WDT-UMP)中的表达及意义.方法 用免疫组织化学法检测38例WDT-UMP、80例甲状腺乳头状癌(papillary thyroid carcinoma,PTC)和40例良性甲状腺病变周围正常组织(对照组)中CK19、Galectin-3、HBME-1和TPO的表达情况.结果 WDT-UMP中CK19、Galectin-3、HBME-1和TPO的阳性率分别为55.2%、68.4%、60.5%和86.8%;CK19、Galectin-3和HBME-1以弱阳性或阴性为主,TPO呈弱阳性至强阳性表达.PTC中CK19、Galectin-3、HBME-1和TPO的阳性率分别为100.0%、95.0%、97.5%和7.5%;CK19、Galectin-3和HBME-1以弥漫强阳性表达为主,TPO以阴性表达为主.对照组中CK19、Galectin-3、HBME-1和TPO的阳性率分别为10.0%、7.5%、5.0%和97.5%;CK19、Galectin-3和HBME-1基本不表达或弱阳性表达,TPO以强阳性表达为主.CK19、Galectin-3和HBME-1在PTC中的表达均高于WDT-UMP(均P<0.01).CK19、Galectin-3和HBME-1在PTC和WDT-UMP中的表达均高于对照组(均P<0.01).TPO在PTC中的表达低于WDT-UMP和对照组(均P<0.01).联合应用CK19、Galectin-3、HBME-1和TPO鉴别PTC与WDT-UMP时,可获得较高的敏感度、特异度和诊断准确率,分别为96.2%、50.6%和81.6%.结论 CK19、Galectin-3、HBME-1和TPO可作为鉴别WDT-UMP、PTC和甲状腺良性病变的潜在标志物.

Expression and significance of CK19,Galectin-3,HBME-1 and TPO in well-differentiated thyroid tumors of uncertain malignant potential

Objective To investigate the expression and clinical significance of cytokeratin 19(CK19),Galectin-3, Hector Battifora mesothelial cell-1(HBME-1)and thyroid peroxidase(TPO)in well-differentiated thyroid tumors of uncer-tain malignant potential (WDT-UMP).Methods The expressions of CK19,Galectin-3,HBME-1 and TPO were examined by immunohistochemical method in 38 cases of WDT-UMP,80 cases of papillary thyroid carcinoma (PTC)and 40 cases of adjacent normal tissues of benign thyroid lesions (control group).Results The positive rates of CK19,Galectin-3,HBME-1 and TPO were 55.2%,68.4%,60.5% and 86.8%,respectively,in WDT-UMP tissues.Among them,CK19,Galectin-3 and HBME-1 were weakly positive or negative,whereas TPO was weak positive to strong positive.In PTC samples,the posi-tive rates of CK19,Galectin-3,HBME-1 and TPO were 100.0%,95.0%,97.5% and 7.5%,respectively.Among them, CK19,Galectin-3 and HBME-1 showed diffusively strong positive expression,yet TPO was largely negative.In the control group,the positive rates of CK19,Galectin-3,HBME-1 and TPO were 10.0%,7.5%,5.0% and 97.5%,respectively. Among them,CK19,Galectin-3 and HBME-1 were negative or weak positive,whereas TPO was strong positive.Moreover,the expressions of CK19,Galectin-3 and HBME-1 were significantly higher in PTC than those in WDT-UMP (all P <0.01). The expressions of CK19,Galectin-3 and HBME-1 were higher in PTC group and WDT-UMP group,compared with the con-trol group (both P <0.01).The expression of TPO was lower in PTC group,compared with WDT-UMP group or the control group (both P <0.01).Finally,the combination test of CK19,Galectin-3,HBME-1 and TPO showed high sensitivity,speci-ficity and accuracy in the differential diagnosis of PTC and WDT-UMP,which were 96.2%,50.6% and 81.6%,respective-ly.Conclusion CK19,Galectin-3,HBME-1 and TPO can be used as potential markers in differentiating WDT-UMP,PTC and benign thyroid lesions.