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目的寻找更好的标记物,用于甲状腺乳头状癌的诊断与鉴别。方法以甲状腺乳头状癌(PTC)为研究组,以甲状腺滤泡状腺瘤(FA)和良性乳头状病变(BPL)作对照组。经自制组织芯片和免疫组化技术,对Twist、Galectin-3、HBME-1、p14ARF和TPO进行标记,并与CK19对比实验。结果6种指标阳性表达率依次为:PTC组100.0%、95.6%、80.0%、28.9%、15.6%和78.0%;FA组0.0、11.1%、6.7%、75.6%、88.9%和0.0;BPL组7.0%、7.5%、2.5%、77.5%、100.0%和0.0。PTC组与FA和BPL组比较差异均有显著性(P<0.05)。6种指标的灵敏度、特异度、准确度分别为100.0%、95.6%、80.0%、71.1%、84.4%、78.0;96.4%、90.1%、95.3%、76.5%、94.1%、100.0%和97.7%、92.3%、90.0%、74.6%、90.8%、91.9%。结论在PTC中6种指标阳性表达率最高的为Twist,其次为Galectin-3,因此临床病理工作中标记Twist和Galectin-3鉴别PTC与FA或BPL有实用意义。Twist的灵敏度和准确度最高,CK19特异度最高。因此该2种指标联合使用对于PTC的鉴别诊断最可靠。
Objective To find a better marker for the diagnosis and differential diagnosis of papillary thyroid carcinoma. Methods Thyroid papillary carcinoma (PTC) was used as the study group, thyroid follicular adenoma (FA) and benign papillary lesions (BPL) as control group. Twist, Galectin-3, HBME-1, p14ARF and TPO were labeled by home-made tissue microarray and immunohistochemistry, and compared with CK19. Results The positive rates of the six indexes were 100.0%, 95.6%, 80.0%, 28.9%, 15.6% and 78.0% in the PTC group, 0.0,11.1%, 6.7%, 75.6%, 88.9% and 0.0% in the FA group, 7.0%, 7.5%, 2.5%, 77.5%, 100.0% and 0.0. The difference between PTC group and FA and BPL group was significant (P <0.05). The sensitivity, specificity and accuracy of the six indexes were 100.0%, 95.6%, 80.0%, 71.1%, 84.4%, 78.0; 96.4%, 90.1%, 95.3%, 76.5%, 94.1%, 100.0% and 97.7% , 92.3%, 90.0%, 74.6%, 90.8%, 91.9%. Conclusion The highest positive expression rate of six markers in PTC is Twist, followed by Galectin-3, so it is practical to differentiate PTC from FA or BPL in clinicopathological markers of Twist and Galectin-3. Twist has the highest sensitivity and accuracy with the highest CK19 specificity. Therefore, the combination of the two indicators for the differential diagnosis of PTC is the most reliable.