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目的探讨半乳糖凝集素-3(galectin-3,Gal-3)和细胞角蛋白-19(cytokeratin-19,CK-19)在桥本甲状腺炎(HT)合并微小甲状腺乳头状癌(PTMC)不同组织中的表达及其临床意义。方法收集25例HT合并良性结节患者(HT合并良性结节组)、25例PTMC患者(PTMC组)及25例HT合并PTMC患者(HT合并PTMC组)的肿瘤结节组织、距离肿瘤0.5 cm以远的正常甲状腺组织及对侧叶正常甲状腺组织,采用免疫组织化学法检测不同组织中Gal-3和CK-19的表达。结果①PTMC组和HT合并PTMC组的结节组织中Gal-3和CK-19的表达阳性率均明显高于HT合并良性结节组(P<0.05)。②HT合并良性结节组和HT合并PTMC组的对侧叶组织中Gal-3和CK-19的表达阳性率均明显高于PTMC组(P<0.05)。③HT合并良性结节组和HT合并PTMC者的距肿瘤0.5 cm组织中Gal-3和CK-19的表达阳性率均明显高于PTMC组(P<0.05)。④在HT合并PTMC组的距肿瘤0.5 cm组织中Gal-3和CK-19表达中阳性和强阳性率均分别明显高于HT合并良性结节组和PTMC组(P<0.05)。结论①Gal-3和CK-19联合检测可作为鉴别甲状腺良、恶性肿瘤指征;②伴HT疾病中Gal-3和CK-19的表达水平明显高于不伴HT疾病的正常甲状腺组织中的表达情况,提示HT疾病易癌变;③Gal-3和CK-19联合检测有助于HT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;④HT合并PTMC时,应扩大手术范围,以行侧叶加对侧叶大部分切除或全叶切除为宜。
Objective To investigate the effects of galectin-3 (Gal-3) and cytokeratin-19 (CK-19) on Hashimoto’s thyroiditis (HT) combined with papillary thyroid carcinoma (PTMC) Expression in tissues and its clinical significance. Methods Tumor nodules were collected from 25 patients with HT with benign nodules (HT with benign nodules), 25 with PTMC (PTMC) and 25 with HT with PTMC (HT with PTMC) The expression of Gal-3 and CK-19 in different tissues was detected by immunohistochemical method in the normal thyroid tissue and the normal thyroid tissue in the contralateral lobe. Results ① The positive rates of Gal-3 and CK-19 in PTMC group and HT-combined PTMC group were significantly higher than those in benign nodular HT group (P <0.05). (2) The positive rates of Gal-3 and CK-19 in the HT tissues of the benign nodules with HT group and the PTMC group were significantly higher than that of the PTMC group (P <0.05). (3) The positive expression rates of Gal-3 and CK-19 in 0.5 cm tumor with HT combined with PTMC in HT group were significantly higher than those in PTMC group (P <0.05). ④ The positive and strong positive rates of Gal-3 and CK-19 in 0.5 cm tumor from HT group were significantly higher than those in benign nodular HT group and PTMC group (P <0.05). Conclusions ① The combined detection of Gal-3 and CK-19 can be used as an indicator of benign and malignant thyroid neoplasms. ② The expression of Gal-3 and CK-19 in HT patients is significantly higher than that in normal thyroid tissues without HT disease (3) The combined detection of Gal-3 and CK-19 may contribute to the judgment of malignant transformation of HT and the early diagnosis of thyroid cancer, especially in the strong positive expression, it should be considered as malignant; (4) When HT combined PTMC , Should expand the scope of surgery to line lateral plus most of the lateral lobectomy or total lobectomy is appropriate.