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目的探讨高分子量角蛋白(HCK)、人骨髓内皮细胞标记物(HBME-1)及甲状腺过氧化物酶(TPO)3个蛋白标记物在甲状腺良恶性病变中的表达差异,评价其在观察组甲状腺乳头状癌(PTC)与对照组甲状腺良性病变中的临床诊断价值。方法采用免疫组化方法检测并比较268例PTC与134例甲状腺良性病变组织中HCK、HBME-1及TPO的表达,分析3个蛋白标记物与PTC临床病理特征的相关性,并计算上述指标对PTC的诊断效能。结果观察组中HCK、HBME-1的阳性表达率分别为96.64%(259/268)、95.15%(255/268),TPO的阴性表达率为88.48%(237/268),与对照组比较差异均有统计学意义(P<0.01)。不同性别、年龄、病灶数目、肿瘤大小、被膜是否突破、淋巴结转移状况、TNM分期及复发危险度PTC患者HCK、HBME-1、TPO表达的差异均无统计学意义(均P>0.05)。HCK、HBME-1及TPO诊断PTC的灵敏度分别为96.64%(259/268)、95.15%(255/268)、88.48%(237/268),特异度分别为91.79%(123/134)、84.33%(113/134)、95.52%(128/134),准确度分别为95.02%(382/402)、91.54%(368/402)、90.79%(365/402)。结论 HCK、HBME-1及TPO在甲状腺良恶性病变中的表达差异有统计学意义,其对鉴别甲状腺结节的良恶性质具有重要的临床价值。
Objective To investigate the expression differences of high-molecular-weight keratin (HCK), human bone marrow endothelial cell marker (HBME-1) and thyroid peroxidase (TPO) in benign and malignant thyroid lesions, and to evaluate them in the observation group. Clinical diagnostic value of thyroid papillary carcinoma (PTC) and benign thyroid lesions in control group. Methods The expressions of HCK, HBME-1 and TPO in 268 PTC cases and 134 benign thyroid lesions were detected by immunohistochemical method. The correlation between the three protein markers and clinicopathological characteristics of PTC was analyzed. The above indexes were calculated. The diagnostic efficacy of PTC. Results The positive expression rates of HCK and HBME-1 in the observation group were 96.64% (259/268) and 95.15% (255/268) respectively, and the negative expression rate of TPO was 88.48% (237/268), which was different from the control group. All had statistical significance (P<0.01). There were no significant differences in the expression of HCK, HBME-1, and TPO in PTC patients with different sex, age, number of lesions, tumor size, whether the capsule was breached, lymph node metastasis status, TNM stage, and risk of recurrence (all P>0.05). The sensitivities of HCK, HBME-1, and TPO in diagnosis of PTC were 96.64% (259/268), 95.15% (255/268), 88.48% (237/268), and the specificities were 91.79% (123/134), 84.33, respectively. The accuracy was 95.02% (382/402), 91.54% (368/402), and 90.79% (365/402), respectively (113/134) and 95.52% (128/134). Conclusions The expressions of HCK, HBME-1 and TPO in benign and malignant thyroid lesions have statistically significant differences. It has important clinical value in distinguishing benign and malignant nature of thyroid nodules.