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目的:探讨CD147检测在细针穿刺活检未能明确细胞学诊断的甲状腺结节中的临床应用价值。方法:选择2013年10月—12月收治的甲状腺结节患者,对术后手术标本进行细针穿刺涂片,用Bethesda甲状腺细胞学报告系统评价腺细胞病理学,选择36例“可疑恶性肿瘤”标本行免疫组化CD147染色分析。CD147阳性者作恶性诊断,结果与手术后石蜡病理结果比较。结果:CD147检测诊断良性病变19例(52.78%),恶性病变17例(47.22%),术后病理检查诊断良性病变16例(44.44%),恶性病变20例(55.56%);甲状腺恶性标本中CD147的阳性表达率明显高于良性标本(P<0.05)。CD147的表达与甲状腺结节是否钙化(CD147阳性率89.47%)及淋巴转移(CD147阳性率100%)有关(P<0.05)。细针穿刺细胞学联合CD147免疫组化染色鉴别甲状腺结节良、恶性的准确性和敏感度分别为91.67%和85.0%。结论:CD147可以作为甲状腺肿瘤细胞学诊断分子生物学标志物,细针穿刺细胞学联合CD147免疫组化分析,有助于提高甲状腺癌的术前检出率。
Objective: To investigate the clinical value of CD147 detection in thyroid nodules that have not been clearly diagnosed by fine needle aspiration biopsy. Methods: Thyroid nodules from October 2013 to December 2013 were selected. Fine needle aspiration biopsy was performed on postoperative surgical specimens. Glandular cytopathology was evaluated by Bethesda thyroid cytology reporting system. Thirty-six patients with suspected malignant tumors "Specimens line immunohistochemical staining of CD147. CD147 positive for malignant diagnosis, the results with paraffin pathological results after surgery. Results: 19 cases (52.78%) were diagnosed benign lesions by CD147 and 17 cases (47.22%) with malignant lesions, 16 cases (44.44%) were pathologically diagnosed benign lesions and 20 cases (55.56%) were malignant lesions. The positive rate of CD147 expression was significantly higher than that of benign (P <0.05). CD147 expression and thyroid nodule calcification (CD147 positive rate 89.47%) and lymph node metastasis (CD147 positive rate of 100%) (P <0.05). The accuracy and sensitivity of fine needle aspiration cytology and CD147 immunohistochemistry in differentiating thyroid nodules were 91.67% and 85.0%, respectively. Conclusion: CD147 can be used as a cytologic diagnostic biomarker for thyroid tumors. Combined with fine needle aspiration cytology and CD147 immunohistochemistry, it is helpful to improve the preoperative detection rate of thyroid cancer.