| 摘要: |
| 目的 探讨细胞角蛋白19（CK19）、半乳糖凝集素3（Gal-3）、p53、拓扑异构酶Ⅱ（TopoⅡ）、Ki-67、细胞周期蛋白D1（CCND1）、人骨髓内皮细胞标志物1（HBME-1）、B-Raf原癌基因丝氨酸/苏氨酸蛋白激酶V600E突变型（BRAFV600E）在甲状腺乳头状癌（PTC）病理诊断中的临床应用价值。方法 选取100例PTC和40例甲状腺良性病变标本，采用免疫组织化学染色EnVision法检测CK19、Gal-3、p53、TopoⅡ、Ki-67、CCND1和HBME-1在组织中的表达情况，通过荧光PCR检测BRAFV600E在组织中的表达情况。结果 PTC组织中CK19、Gal-3、TopoⅡ、CCND1、HBME-1和BRAFV600E阳性表达率［97.0%（97/100）、98.0%（98/100）、56.0%（56/100）、95.0%（95/100）、66.0%（66/100）、75.0%（75/100）］高于甲状腺良性组织［45.0%（18/40）、20.0%（8/40）、15.0%（6/40）、55.0%（22/40）、25.0%（10/40）、12.5%（5/40）］，差异均有统计学意义（P均<0.01）。8种标志物单独用于PTC的诊断时，CK19、Gal-3的灵敏度最高（97.0%、98.0%），Gal-3的准确度最高（92.9%）；3种标志物联合应用并以其中任意2种阳性作为阳性判断标准时，CK19、Gal-3、HBME-1组合检测PTC的准确度最高（96.4%），其次为BRAFV600E、CK19、Gal-3组合（91.4%）。结论 CK19、Gal-3、TopoⅡ、CCND1、HBME-1、BRAFV600E是诊断PTC的重要标志物，这些标志物联合应用有助于对形态不典型PTC与甲状腺良性病变进行鉴别。 |
| 关键词: 甲状腺乳头状癌 细胞角蛋白19 半乳糖凝集素3 B-Raf原癌基因丝氨酸/苏氨酸蛋白激酶 p53 拓扑异构酶Ⅱ Ki-67 细胞周期蛋白D1 人骨髓内皮细胞标志物1 |
| DOI：10.16781/j.CN31-2187/R.20220404 |
| 投稿时间：2022-05-11修订日期：2022-09-02 |
| 基金项目:国家自然科学基金（81970868，81972537，81200734）． |
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| Clinical application of specific tumor markers for papillary thyroid carcinoma |
| TENG Wei-qiang,CHEN Meng-jie,HAN Huan,GAO Ying-na,ZHANG Cai-yun,ZHENG Hong-liang,ZHU Cheng-jing* |
(Department of Otorhinolaryngology Head and Neck Surgery, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China
*Corresponding author) |
| Abstract: |
| Objective To investigate the clinical application of cytokeratin 19 (CK19), galectin-3 (Gal-3), p53, topoisomerase Ⅱ (TopoⅡ), Ki-67, cyclin D1 (CCND1), human bone marrow endothelial marker 1 (HBME-1), and B-Raf proto-oncogene, serine/threonine kinase V600E mutant type (BRAFV600E) in the pathological diagnosis of papillary thyroid carcinoma (PTC). Methods A total of 100 PTC and 40 benign thyroid lesions were selected. The expression of CK19, Gal-3, p53, TopoⅡ, Ki-67, CCND1 and HBME-1 in tissues was detected by immunohistochemistry EnVision method, and the expression of BRAFV600E was detected by fluorescence polymerase chain reaction. Results The positive expression rates of CK19, Gal-3, TopoⅡ, CCND1, HBME-1 and BRAFV600E in PTC tissues (97.0%[97/100], 98.0%[98/100], 56.0%[56/100], 95.0%[95/100], 66.0%[66/100] and 75.0%[75/100]) were significantly higher than those in benign thyroid tissues (45.0%[18/40], 20.0%[8/40], 15.0%[6/40], 55.0%[22/40], 25.0%[10/40] and 12.5%[5/40]), and the differences were statistically significant (all P<0.01). CK19 and Gal-3 had the highest sensitivity (97.0% and 98.0%, respectively) and Gal-3 had the highest accuracy (92.9%) when the 8 markers were used alone for the diagnosis of PTC. Taking any 2 being positive of a 3 combination as the positive criterion, the combined application of CK19, Gal-3 and HBME-1 as diagnostic criteria for PTC had the highest accuracy of 96.4%. The combication of BRAFV600E, CK19 and Gal-3 showed high accuracy as well (91.4%). Conclusion CK19, Gal-3, TopoⅡ, CCND1, HBME-1 and BRAFV600E are important markers for the diagnosis of PTC, and the combined application of these markers can help to distinguish the abnormal PTC from benign thyroid lesions. |
| Key words: papillary thyroid carcinoma cytokeratin 19 galectin-3 B-Raf proto-oncogene, serine/threonine kinase p53 topoisomerase Ⅱ Ki-67 cyclin D1 human bone marrow endothelial marker 1 |
