摘要
目的观察并评估TI-RADS 4a类甲状腺结节穿刺组织中HBME-1、CD56、CK19和galectin-3蛋白表达异常对病理诊断的作用和意义。方法选取天津中医药大学第一附属医院2016年4月至2018年4月收治的,经彩超诊断为TI-RADS 4a类结节181例,共181个结节,进行甲状腺粗针穿刺活检,穿刺活检后,对TI-RADS 4a结节行超声引导下射频消融治疗。穿刺组织行石蜡包埋、切片、HE染色,同时采用免疫组化法检测HBME-1、CD56、CK19、galectin-3的蛋白表达水平,并进行统计学分析。结果 181例TI-RADS 4a类结节的甲状腺患者,经粗针穿刺组织病理诊断证实:单纯性结节性甲状腺肿(不伴腺瘤样增生性结节)79例,单纯性滤泡性腺瘤(不伴结节性甲状腺肿)52例,乳头状癌50例。采用免疫组化法检测181例穿刺组织HBME-1、CD56、CK19和galectin-3,其阳性表达率分别为:25.97%、74.03%、33.15%和30.39%,其中,结节性甲状腺肿1.27%、96.20%、8.86%、3.80%;滤泡性腺瘤1.92%、96.15%、7.69%、5.77%;甲状腺乳头状癌90%、16%、98%、98%。HBME-1、CK19和galectin-3在甲状腺乳头状癌阳性表达率较高(P <0.05),CD56在结节性甲状腺肿的阳性表达率较高(P <0.05)。结论粗针穿刺活检是明确TI-RADS 4a类结节性质的重要方法之一;HBME-1、CD56、CK19和galectin-3蛋白在TI-RADS 4a类结节中异常表达对病理鉴别诊断具有重要价值。
Objective To observe and evaluate diagnosis value of aberrant level of HBME-1,CK19,CD56 and galectin-3 protein expression in TI-RADS 4a thyroid nodule treated by ultrasound guided core needle bi opsy.Method A total of 181 nodules with TI-RADS 4a,First Teaching Hospital of Tianjin University of Tradi tional Chinese Medicine within April,2016 and April,2018,were treated with ultrasound-guided radiofrequency ablation of the thyroid gland after core needle biopsy,biopsy tissue paraffin embedding,sectioning,HE staining,and at the same time using immunohistochemical method to detect 181 cases of biopsy tissue,CD56,CK19,galec tin-3 and HBME-1 of protein expression levels.Results 181 thyroid nodules with TI-RADS 4a,verified by patho logical diagnosis,were composed of 79 cases of nodular goiter without follicular adenoma,52 cases of follicular ad enoma without nodular goiter and 50 cases of papillary thyroid carcinoma.The positive expression rate of HBME-1,CD56,CK19 and galectin-3,is 25.97%,74.03%,33.15%and 30.39%by immune-histochemical method.The posi tive expression rate in three pathological types of is 0%in nodular goiter,1.27%,96.20%,8.86%,3.80%;1.92%,96.15%,7.69%,5.77%in follicular adenoma;90%,16%,90%,98%in papillary thyroid carcinoma.There are significant differences in HBME-1,CD56,CK19 and galectin-3 between papillary thyroid carcinoma and the other two pathological types(P<0.05).However,no significant difference in protein positive expression rate was ob served between the other two pathological types(P >0.05).Conclusions Core needle biopsy is regarded as a vi tal method of figuring out benign or malignant of thyroid nodule with TI-RADS 4a.Aberrant level of HBME-1、CK19、CD56 and galectin-3 has great important pathological diagnosis value for thyroid nodule with TI-RADS 4a.
作者
吕艳
李翀
葛善义
耿强
韩燕燕
兰福
赵杰
郑旭
Lü Yan;LI Chong;GE Shanyi;GENG Qiang;HAN Yanyan;LAN Fu;ZHAO Jie;ZHENG Xu(Pathology Department,First Teaching Hospital of Tianjin University of TCM,Tianjin 300381,China)
出处
《实用医学杂志》
CAS
北大核心
2019年第2期294-298,共5页
The Journal of Practical Medicine
