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目的:探讨CKl9、AAT、TPO、CD56和Galectin-3在甲状腺乳头状癌中的表达、诊断与鉴别诊断的意义。方法:收集宁夏第五人民医院病理科2011年1月至2015年5月手术切除的PTC标本存档蜡块38例(微小乳头状癌10例,经典型乳头状癌28例),男12例,女26例,年龄16-72岁,中位年龄44岁。应用免疫组织化学方法免疫组织化学En Vision法检测组织中CD56、TPO、CKl9、Galectin-3和AAT的表达。结果:CD56表达定位在细胞膜,TPO、AAT及CK19表达定位在细胞质,Galectin-3表达定位在细胞核、细胞质。PTC中5种标志物表达情况:CKl9:94.7%(36/38);Galectin-3:97.3%(37/38);AAT:100%(38/38);CD56:10.5%(4/38);TPO:7.8%(3/38)。5种标志物单独用于PTC的诊断时,CK19及Galectin-3的灵敏度和特异度最高,AAT阳性表达较弱,但均有>10%的细胞质阳性表达。CK19,Galectin-3及AAT同时阳性与TPO、CD56同时阴性作为诊断PTC的主要依据时,特异度和灵敏度最佳。结论:对于那些非典型性的甲状腺乳头状癌,CD56、TPO、CKl9、Galectin-3和CD56的联合应用将有助于PTC的诊断。
Objective: To investigate the expression, diagnosis and differential diagnosis of CK19, AAT, TPO, CD56 and Galectin-3 in papillary thyroid carcinoma. Methods: Thirty-eight paraffin blocks (mini papillary carcinoma, 28 classic papillary carcinomas) were collected from January 2011 to May 2015 in Department of Pathology, Ningxia Fifth People’s Hospital. There were 12 males, 26 females, aged 16-72 years old, the median age of 44 years. The expression of CD56, TPO, CKl9, Galectin-3 and AAT were detected by immunohistochemistry immunohistochemistry En Vision method. Results: The expression of CD56 was located in the cell membrane. The expression of TPO, AAT and CK19 was localized in the cytoplasm. The expression of Galectin-3 was localized in the nucleus and cytoplasm. Expression of five markers in PTC: CKl9: 94.7% (36/38); Galectin-3: 97.3% (37/38); AAT: 100% ; TPO: 7.8% (3/38). The sensitivity and specificity of CK19 and Galectin-3 were the highest when the five markers were used alone for the diagnosis of PTC. The positive expression of AAT was weak, but the positive expression of cytoplasm was> 10%. The specificity and sensitivity of CK19, Galectin-3 and AAT both positive and TPO and CD56 negative at the same time as the main basis for the diagnosis of PTC. CONCLUSIONS: The combination of CD56, TPO, CKl9, Galectin-3 and CD56 will contribute to the diagnosis of PTC in those patients with atypical thyroid papillary carcinoma.