摘要
目的探讨免疫学标记在甲状腺细针抽吸细胞学诊断中应用的价值。方法用免疫细胞化学方法观察938例甲状腺细针抽吸标本涂片中各种甲状腺疾病的细胞形态及HLA-DR、S-100和CD44蛋白表达。结果诊断或提示可能性诊断为良性病变(慢性淋巴细胞性甲状腺炎、结节性甲状腺肿、临床甲状腺功能亢进、甲状腺腺瘤、亚急性甲状腺炎)约占80%。不能诊断或不能提示可能性诊断的各种疾病(含陈旧性出血)约占16%。恶性肿瘤的诊断比例不足4%。提示可能性诊断为慢性淋巴细胞性甲状腺炎、临床甲状腺功能亢进涂片的甲状腺滤泡上皮胞浆中HLA-DR表达阳性率分别为47.9%和15.8%。而S-100蛋白在良、恶性病变中均有程度不同的表达。CD44棕黄色免疫阳性反应物见于提示可能性诊断为恶性病变中92%的异形细胞胞膜,未见于其他细胞中。结论HLA-DR抗原表达在弥漫性毒性甲状腺肿、桥本甲状腺炎有助于与其他有淋巴细胞浸润疾病的鉴别诊断,CD44阳性表达在高分化滤泡癌,在与腺瘤的鉴别诊断中有一定的参考价值。
Objective To evaluate the significance of immune markers in cytologic diagnosis of thyroid diseases with fine-needle aspiration （FNA）. Methods A morphologic study and HLA-DR, S-100 and CD44 expressions by cytochemical and immunocytochemical techniques were performed for cytologic diagnosis of thyroid diseases in 938 samples with FNA. Results The diagnosed and tentatively diagnosed benign diseases （ including lymphocytic thyroiditis, nodular goiter, clinical hyperthyroidism, adenoma of thyroid, subacute thyroiditis ） accounted for about 80% , undiagnosed cases about 16% and malignant diseases less than 4%. HLA-DR was positive in 47.9% and 15.8% cases of tentatively diagnosed lymphocytic thyroiditis and clinical hyperthyroidism respectively. The S-100 expression was similar in various thyroid diseases. CD44 was positive in 92% of malignant cells, but not in other cells. Conclusion Positive HLA-DR expression coutributes to the differentiating diagnosis of Graves＇ disease and Hashimoto＇s thyroiditis from other thyroid disease with lymphocytic infiltration. Positive CD44 expression has a certain significance in differentiating the well-differentiated follicular carcinoma from benign adenoma of thyroid.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2005年第6期522-526,共5页
Chinese Journal of Endocrinology and Metabolism
