目的 探討半乳糖凝集素-3(galectin-3,Gal-3)和細(xì)胞角蛋白-19(cytokeratin-19,CK-19)在橋本甲狀腺炎(HT)合并微小甲狀腺乳頭狀癌(PTMC)不同組織中的表達(dá)及其臨床意義。
方法 收集25例HT合并良性結(jié)節(jié)患者(HT合并良性結(jié)節(jié)組)、25例PTMC患者(PTMC組)及25例HT合并PTMC患者(HT合并PTMC組)的腫瘤結(jié)節(jié)組織、距離腫瘤0.5cm以遠(yuǎn)的正常甲狀腺組織及對(duì)側(cè)葉正常甲狀腺組織,采用免疫組織化學(xué)法檢測(cè)不同組織中Gal-3和CK-19的表達(dá)。
結(jié)果 ①PTMC組和HT合并PTMC組的結(jié)節(jié)組織中Gal-3和CK-19的表達(dá)陽(yáng)性率均明顯高于HT合并良性結(jié)節(jié)組(P<0.05)。②HT合并良性結(jié)節(jié)組和HT合并PTMC組的對(duì)側(cè)葉組織中Gal-3和CK-19的表達(dá)陽(yáng)性率均明顯高于PTMC組(P<0.05)。③HT合并良性結(jié)節(jié)組和HT合并PTMC者的距腫瘤0.5 cm組織中Gal-3和CK-19的表達(dá)陽(yáng)性率均明顯高于PTMC組(P<0.05)。④在HT合并PTMC組的距腫瘤0.5 cm組織中Gal-3和CK-19表達(dá)中陽(yáng)性和強(qiáng)陽(yáng)性率均分別明顯高于HT合并良性結(jié)節(jié)組和PTMC組(P<0.05)。
結(jié)論 ?、貵al-3和CK-19聯(lián)合檢測(cè)可作為鑒別甲狀腺良、惡性腫瘤指征;②伴HT疾病中Gal-3和CK-19的表達(dá)水平明顯高于不伴HT疾病的正常甲狀腺組織中的表達(dá)情況,提示HT疾病易癌變;③Gal-3和CK-19聯(lián)合檢測(cè)有助于HT惡性變傾向的判斷和甲狀腺癌的早期診斷,特別在其強(qiáng)陽(yáng)性表達(dá)中應(yīng)視為已惡變;④HT合并PTMC時(shí),應(yīng)擴(kuò)大手術(shù)范圍,以行側(cè)葉加對(duì)側(cè)葉大部分切除或全葉切除為宜。
引用本文: 徐其銀,程若川. 半乳糖凝集素-3和細(xì)胞角蛋白-19在橋本甲狀腺炎合并微小乳頭狀癌不同組織中的表達(dá). 中國(guó)普外基礎(chǔ)與臨床雜志, 2013, 20(2): 161-164. doi: 復(fù)制
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- 1. Beesley MF, McLaren KM. Cytokeratin 19 and galectin-3 immunohistochemistry in the differential diagnosis of solitary thyroid nodules[J]. Histopathology, 2002, 41(3):236-243.
- 2. Lindsay S, Dailey ME, Friedlander J, et al. Chronic thyroiditis:a clinical and pathologic study of 354 patients[J]. J Clin Endocrinol Metab, 1952, 12(12):1578-1600.
- 3. Arif S, Blanes A, Diaz-Cano SJ. Hashimoto’s thyroiditis shares features with early papillary thyroid carcinoma[J]. Histopathology, 2002, 41(4):357-362.
- 4. 王蘭, 潘丹. 橋本甲狀腺炎伴甲狀腺癌臨床病理分析[J]. 臨床與實(shí)驗(yàn)病理學(xué)雜志, 2003, 19(3):286-289.
- 5. Khalil A, Kaufmann RC, Wortsman J, et al. Inhibin in normal and abnormal pregnancy:maternal serum concentration andpartial characterization[J]. Am J Obstet Gynecol, 1995, 172((3):1019-1025.
- 6. Honjo Y, Inohara H, Akahani S, et al. Expression of cytoplasmicgalectin-3 as a prognostic marker in tongue carcinoma[J]. Clin Cancer Res, 2000, 6(12):4635-4640.
- 7. Xu XC, el-Naggar AK, Lotan R. Differential expression of galectin-1 and galectin-3 in thyroid tumors. Potential diagnostic implications[J]. Am J Pathol, 1995, 147(3):815-822.
- 8. Bartolazzi A, Gasbarri A, Papotti M, et al. Application of animmunodiagnostic method for improving preoperative diagnosis of nodular thyroid lesions[J]. Lancet, 2001, 357(9269):1644-1650.
- 9. Perillo NL, Marcus ME, Baum LG. Galectins:versatile modulators of cell adhesion, cell proliferation, and cell death[J]. J Mol Med, 1998, 76(6):402-412.
- 10. Nangia-Makker P, Honjo Y, Sarvis R, et al. Galectin-3 induces endothelial cell morphogenesis and angiogenesis[J]. Am J Pathol, 2000, 156(3):899-909.
- 11. 彭年春, 郭曉蕙, 袁振芳, 等. CD26/DPPⅣ、galectin-3在甲狀腺乳頭狀癌的表達(dá)及意義[J]. 基礎(chǔ)醫(yī)學(xué)與臨床, 2009, 29(10):1079-1082.
- 12. Rosaí J, Zampi G, Carcangiu ML. Papillary carcinoma of the thyroid. A discussion of its several morphologic expressions, with particular emphasis on the follicular variant[J]. Am J Surg Pathol, 1983, 7(8):809-817.
- 13. Sahoo S, Hoda SA, Rosai J, et al. Cytokeratin 19 immunoreactivity in the diagnosis of papillary thyroid carcinoma:a note of caution[J]. Am J Clin Pathol, 2001, 116(5):696-702.
- 14. Miettinen M, Kovatich AJ, Kärkkäinen P. Keratin subsets in papillary and follicular thyroid lesions. A paraffin section analysis with diagnostic implications[J]. Virchows Arch, 1997, 431(6):407-413.
- 15. 賈萬(wàn)鈞, 郭艷. CK19、gal-3、HBME-1和Ret蛋白在甲狀腺乳頭狀癌中的表達(dá)[J]. 浙江臨床醫(yī)學(xué), 2007, 9(11):1143-1144.
- 16. 王儀, 魏霖, 陳昕. Galectin-3、CK19和MC在甲狀腺良、惡性腫瘤中的表達(dá)及意義[J]. 海峽藥學(xué), 2007, 19(12):108-110.
- 17. Kazantseva IA, Fedosenko AK, Gurevich LE. Immunohistochemical study in differential diagnosis of benign and malignant lesions of the thyroid gland[J]. Arkh Patol, 2001, 63(4):18-21.
- 18. 王家耀. 橋本甲狀腺炎與甲狀腺癌的關(guān)系[J]. 診斷病理學(xué)雜志, 1997, 4(2):106-107.
- 19. 戴軍, 陳方薈, 包建東, 等. 橋本甲狀腺炎癌變與甲狀腺乳頭狀癌相關(guān)性分析[J]. 診斷病理學(xué)雜志, 2005, 12(6):458-459, 501.
- 20. Di Pasquale M, Rothstein JL, Palazzo JP. Pathologic features of Hashimoto’s-associated papillary thyroid carcinomas[J]. Hum Pathol, 2001, 32(1):24-30.