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目的:探讨AgNOR个数、DNA含量、P53、PCNA表达在甲状腺滤泡性肿瘤诊断中的意义。方法:应用胶银染色法行AgNOR计数、FCM行细胞核DNA含量测定,间接免疫荧光标记通过FCM行P53的定性和定量检测,免疫组化方法检测PCNA在甲状腺滤泡性肿瘤中的表达,分析AgNOR个数、DNA含量及P53基因蛋白和PCNA表达与滤泡性肿瘤的组织学类型的关系。结果:AgNOR计数在正常甲状腺上皮、腺瘤与腺瘤伴上皮增生活跃和腺癌间差异有显著性(P<0.05)。腺瘤伴上皮增生活跃与腺癌间差异无显著性(P>0.05)。DNA含量在正常甲状腺与腺瘤之间差异无显著性(P>0.05)。而正常甲状腺上皮、腺瘤与腺瘤伴上皮增生活跃和腺癌间差异有显著性(P<0.01),而腺瘤伴上皮增生活跃与腺癌之间差异无显著性(P>0.05)。P53基因蛋白表达在正常上皮与腺瘤间差异无显著性(P>0.05);与腺瘤伴上皮增生活跃、腺癌间差异有显著性(P<0.01)。腺瘤与腺瘤伴上皮增生活跃和腺癌间差异有显著性(P<0.05)。而腺瘤伴上皮增生活跃与腺癌间差异无显著性(P>0.05)。PCNA表达在正常上皮与腺瘤间差异无显著性(P>0.05);与腺瘤伴上皮增生活跃、腺癌间差异有显著性(P<0.01)。腺瘤与腺瘤伴上皮增生活跃和腺癌间差异有显著性(P<0.05)。而腺瘤伴上皮增生活跃与腺癌间差异无显著性(P>0.05)。结论:在甲状腺滤泡性肿瘤的鉴别中行AgNOR计数意义不大,而行DNA含量测定及P53基因蛋白的定量和PCNA检测有一定的意义。
Objective: To investigate the significance of AgNOR number, DNA content, P53 and PCNA expression in the diagnosis of thyroid follicular tumors. Methods: AgNOR count, FCM nuclear DNA content were determined by gel electrophoresis, the qualitative and quantitative detection of P53 by FCM was performed by indirect immunofluorescence staining, the expression of PCNA in thyroid follicular tumors was detected by immunohistochemistry, and the expression of AgNOR Number, DNA content, P53 gene protein and PCNA expression and the histological type of follicular tumors. Results: The AgNOR counts in normal thyroid epithelium, adenoma and adenoma with epithelial hyperplasia and adenocarcinoma were significantly different (P <0.05). There was no significant difference between adenoma with epithelial hyperplasia and adenocarcinoma (P> 0.05). There was no significant difference in DNA content between normal thyroid and adenoma (P> 0.05). However, there was a significant difference between normal thyroid epithelium, adenoma and adenoma with epithelial hyperplasia and adenocarcinoma (P <0.01), but there was no significant difference between adenoma with epithelial hyperplasia and adenocarcinoma (P> 0.05). P53 gene protein expression in normal epithelium and adenoma no significant difference (P> 0.05); and adenoma with epithelial hyperplasia, adenocarcinoma was significantly different (P <0.01). There was a significant difference between adenoma and adenoma with epithelial hyperplasia and adenocarcinoma (P <0.05). There was no significant difference between adenoma with epithelial hyperplasia and adenocarcinoma (P> 0.05). There was no significant difference in PCNA expression between normal epithelium and adenoma (P> 0.05). There was a significant difference between adenocarcinoma and adenoma with adenoma (P <0.01). There was a significant difference between adenoma and adenoma with epithelial hyperplasia and adenocarcinoma (P <0.05). There was no significant difference between adenoma with epithelial hyperplasia and adenocarcinoma (P> 0.05). CONCLUSION: AgNOR counting is not meaningful in the identification of follicular thyroid tumors. However, the determination of DNA content and the quantification of P53 gene protein and PCNA are of certain significance.