【作者】 徐其银；

【导师】 程若川； 张建明； 罗华友；

【作者基本信息】 昆明医学院 ， 外科学， 2010， 硕士

【摘要】 【目的】探讨Gal-3和CK-19在桥本甲状腺炎并微小乳头状癌中不同区域的表达情况及其临床意义。【方法】将临床收集的标本按照病理学诊断,分为桥本甲状腺炎并结节,微小乳头状癌和桥本甲状腺炎并微小乳头状癌三组；采用免疫组织化学法检测对照组A：25例桥本甲状腺炎合并发良性结节的组织(瘤组织,距瘤组织0.5CM的甲状腺组织,对侧叶),对照组B：25例微小乳头状甲状腺癌的组织(癌组织,距癌组织0.5CM的甲状腺组织,对侧叶)实验组：25例桥本氏病并微小乳头状癌的组织(癌组织,距癌组织0.5CM的甲状腺组织,对侧叶)中Gal-3和CK-19的表达。【结果】本研究结果表明,正常甲状腺组织中Galectin-3和CK-19表达很低；对照A组其距肿瘤0.5cm处表达Galectin-3阳性率为52%(13/25),CK-19为44%(11/25)显著高于对照B组0.5cm区域(P<0.05)。实验组中距肿瘤0.5cm区域Galectin-3阳性率76%(19/25),CK-19为68%(17/25)明显高于对照A、B两组组,与对照B组行统计学分析其差异有统计学意义(P<0.05),但与对照A组行统计学分析其差异无统计学意义(P>0.05)。对照A组距肿瘤0.5cm区域Galectin-3、CK-19阳性表达：弱阳性分别为69.23%(9/13)、72.73%(8/11)；中阳性分别为23.08%(3/13)、18.18%(2/11),强阳性分别为7.69%(1/13)、9.09%(1/11)；而在实验组距肿瘤0.5cm区域中,Galectin-3、CK-19阳性表达：弱阳性分别为36.84%(7/19)、29.41%(5/17)；中阳性分别为36.84%(7/19)、47.06%(8/17),强阳性分别为26.32%(5/19)、23.53%(4/17)；对两组中阳性和强阳性分别比较其差异有统计学意义(P值均<0.05)。【结论】1. Galectin-3和Cytokeratin-19的联合检测可作为鉴别甲状腺良恶性肿瘤指征。2.桥本甲状腺炎中Galectin-3和Cytokeratin-19的表达水平明显高于正常甲状腺组织中的表达情况,提示在一定程度上桥本甲状腺炎增加了癌变可能。3. Galectin-3、CK-19联合检测有助于桥本甲状腺炎恶性变倾向的判断和甲状腺癌的早期诊断,特别在其强阳性表达中应视为已恶变。4.桥本甲状腺炎合并微小乳头状癌时,应行手术治疗,而且应扩大手术范围,行侧叶加对侧叶大部分切除或全叶切除为宜。更多还原

【Abstract】 [Objective] To detect the expression of galectin-3 and cytokeratin-19 in different area of Hashimoto thyroiditis with thyroid papillary microcarcinoma[Methods] Immunohistochemical methods used to examine expression of galectin-3 and cytokeratin-19 in the area of tumor,0.5cm near the tumor and other lobec thyroid in 25 Hashimoto thyroiditis patients,25 thyroid papillary microcarcinoma patents,25 Hashimoto thyroiditis with thyroid papillary microcarcinoma patients[Results] the research results indicated,the lower expression of galectin-3 and cytokeratin-19 in normal thyroid,s tissue;The positive rate of Galectin-3 and CK-19 in the area of 0.5cm near the tumor of the contrast group A were 52%(13/25)and 44 %(11/25) which were superior than what in the contrast group B(P<0.05);but indicated no difference between the contrast group A(P>0.05); The positive rate of Galectin-3 and CK-19 in the area of 0.5cm near the tumor of the contrast group A were Weak positive 69.23%(9/13),72.73%(8/11).positive 23.08%(3/13),18.18 %(2/11)and Strong positive 7.69%(1/13),9.09%(1/11) matched along with Weak positive 36.84%(7/19),29.41%(5/17); positive 36.84%(7/19),47.06% (8/17)and Strong positive 26.32%(5/19),23.53%(4/17)in the test group; the positive and strong positive groups showed evidently difference(P<0.05).[Conclusion]1.Galetin-3 protein assay combined with CK-19 are helpful to differentiate the benign thyroid tumor and malignant one.2.The expression of Galectin-3 and Cytokeratin-19 protein in Hashimoto thyroiditis is clear higher than what in normal thyroid tissue,it is means that prognosis evalution in Hashimoto thyroiditis canceration. 3.Galectin-3 protein assay combined with CK-19 are useful in early diagnosis, the pathogenesis and prognosis evaluation thyroid cancer. When they are strong positive mean it is cancer.4.In Hashimoto thyroiditis with thyroid papillary microcarcinoma,it need a operation therapy, and need a larger one,maybe one total and the other one subtotal or both total.更多还原