目的：探讨Ki67核抗原（Ki67），甲状腺转录因子-1(TTF-1)，人表皮生长因子受体-2（HER-2/neu）和人骨髓内皮细胞-1(HBME-1)对于鉴别诊断甲状腺乳头状癌（papillary thyroid carcinoma, PTC）和甲状腺良性结节的临床意义。方法：回顾分析180例PTC和190例甲状腺良性结节的石蜡切片，采用免疫组化法检测Ki67,TTF-1,HBME-1和HER-2/neu水平。结果：4种标志物在PTC中表达的阳性率明显高于甲状腺良性结节（P=0.000）。采用单一标志物检测时，HER-2/neu的敏感性最高（79.4%），TTF-1的特异性最高(96.8%)。Ki67+HER-2/neu+HBME-13者联合检测的敏感性最高（89.8%），HER-2/neu+TTF-1和HER-2/neu+TTF-1+HBME-1联合检测具有相同的特异性（99.4%，P＜0.01）。结论：在PTC中，Ki67和TTF-1在联合HER-2/neu或（和）HBME-1检测时，可显著提高单项指标检测PTC的敏感性和特异性。%Objective:To investigate the clinical value of differentiation of the papillary thyroid carcinoma (PTC) from the benign thyroid nodules with Ki67 nuclear antigen (Ki67), thyroid transcription factor-l (TTF-1), human epidermal growth factor receptor type-2 (HER-2/neu), and human bone marrow endothelial cell-1(HBME-1). Methods:The paraifn sections of 180 cases with PTC and 190 cases with the benign thyroid nodules were retrospectively analyzed. The levels of Ki67, TTF-1, HBME-1 and HER-2/neu were determined immunohistochemically. Results:The positive rates of the expressions of 4 markers were higher in PTC specimens than in the benign thyroid nodules specimens (P=0.000). When using a single marker, the detection of HER-2/neu had the most sensitivity (79.4%) and that of HBME-1 the most speciifcity (96.8%). The detection combined with Ki67, HER-2/neu and HBME-1 had the most sensitivity (89.8%). The detection combined with HER-2/neu+TTF-1 and HER-2/neu+TTF-1+HBME-1 had the same speciifcity (99.4%, P<0.01). Conclusions:When combining Ki67 and TTF-1 with HER-2/neu or HBME-1, the sensitivity and speciifcity in the single indicator determination can be increased obviously in the diagnosis of PTC.
展开▼
