CK19及Galectin-3在甲状腺乳头状癌合并桥本氏甲状腺炎的表达及临床意义

中华养生保健 ›› 2022, Vol. 40 ›› Issue (21): 40-43.

CK19及Galectin-3在甲状腺乳头状癌合并桥本氏甲状腺炎的表达及临床意义

高丹, 吴影, 付雪莲, 李淑莲, 李化敏, 董祥梅, 付瑶^*

牡丹江医学院附属红旗医院病理诊断中心,黑龙江牡丹江,157000

出版日期:2022-11-01 发布日期:2022-11-01
通讯作者: ^*付瑶,E-mail：274713756@qq.com。
作者简介:高丹（1988.2-）,女,汉族,籍贯：黑龙江省齐齐哈尔市,硕士研究生,主治医师,研究方向：病理学。
基金资助:
“红旗科研基金”科技项目（2018HQ-27）

Expression and clinical significance of CK19 and galectin-3 in thyroid papillary carcinoma complicated with Hashimoto's thyroiditis

GAO Dan, WU Ying, FU Xue-lian, LI Shu-lian, LI Hua-min, DONG Xiang-mei, FU Yao^*

Pathological Diagnosis Center, Hongqi Hospital Affiliated to Mudanjiang Medical College, Mudanjiang Heilongjiang, 157000, China

Online:2022-11-01 Published:2022-11-01

摘要/Abstract

摘要： 目的探讨细胞角蛋白19（cytokeratin 19,CK19）及半乳糖凝集素-3（Galectin-3）在甲状腺乳头状癌合并桥本氏甲状腺炎（papillary thyroid carcinoma with Hashimoto's thyroiditis,PCT-HT）的表达及临床意义。方法选取2017年8月~2021年8月牡丹江医学院附属红旗医院收治的100例PCT-HT患者作为观察组,另选取同期来牡丹江医学院附属红旗医院治疗的100例单纯甲状腺乳头状癌患者作为对照组,进行回顾性分析。对比两组患者临床特征与CK19及Galectin-3表达水平,分析CK19及Galectin-3与PCT-HT的相关性,并应用受试者操作特征曲线（ROC曲线）分析CK19及Galectin-3在PCT-HT的临床意义。结果两组患者性别、年龄、肿瘤直径、淋巴结转移情况对比,差异无统计学意义（P>0.05）,观察组肿瘤侵犯性为无的占比明显低于对照组,临床分期Ⅰ~Ⅱ的占比明显低于对照组,CK19与Galectin-3阳性占比明显高于对照组,差异有统计学意义（P<0.05）;Spearman相关分析结果显示CK19及Galectin-3与PCT-HT呈正相关（r=0.423、0.539,P<0.05）;CK19诊断PCT-HT价值曲线下面积为89.63,最佳诊断着色界限值为75.73%,Galectin-3的曲线下面积为78.89,最佳色界限值为82.53%;Logistic回归分析结果表明CK19及Galectin-3对PCT-HT具有独立预测价值（P<0.05）。结论 PCT-HT患者肿瘤侵犯性、临床分期较高,CK19与Galectin-3阳性表达占比较高,并且CK19免疫组化着色面积>75.73%,Galectin-3>82.53%是PCT-HT的相关危险因素,因此,临床上可针对CK19及Galectin-3表达为阳性的桥本氏甲状腺炎患者及时采取甲状腺乳头状癌的病理检查,从而早期诊断甲状腺癌,并采取针对性治疗措施。

关键词: 甲状腺乳头状癌, 桥本氏甲状腺炎, CK19, Galectin-3

Abstract: Objective To investigate the expression and clinical significance of CK19 and galectin-3 in thyroid papillary carcinoma complicated with Hashimoto's thyroiditis (PCT-HT). Methods 100 patients with pct-ht treated in Hongqi Hospital Affiliated to Mudanjiang Medical College from August 2017 to August 2021 were selected as the research object and divided into the observation group. Another 100 patients with simple thyroid papillary carcinoma treated in our hospital in the same period were selected as the control group. The clinical characteristics and the expression levels of CK19 and Galectin-3 were compared between the two groups, and the correlation between CK19 and Galectin-3 and PCT-HT was analyzed, the clinical significance of CK19 and Galectin-3 in PCT-HT was analyzed by receiver operating characteristic curve (ROC curve). Results There was no significant difference in gender, age, tumor diameter and lymph node metastasis between the two groups (P>0.05). There were significant differences in tumor invasiveness, clinical stage and the expression of CK19 and Galectin-3 between the two groups (P<0.05). The proportion of patients with no tumor invasiveness in the observation group was significantly lower than that in the control group, the proportion of patients with clinical stage I-II was significantly lower than that in the control group, and the proportion of patients with positive CK19 and Galectin-3 was significantly higher than that in the control group; Spearman correlation analysis showed that CK19 and Galectin-3 were positively correlated with pct-ht (r=0.423, 0.539, P<0.05); The area under the diagnostic PCT-HT value curve of CK19 was 89.63, the best diagnostic coloring limit value was 75.73%, the area under the curve of Galectin-3 was 78.89, and the best color limit value was 82.53%. Logistic regression analysis showed that CK19 and Galectin-3 had independent predictive value for PCT-HT (P<0.05). Conclusion Patients with PCT-HT have higher tumor invasiveness and clinical stage, higher number of positive expression of CK19 and Galectin-3, and CK19 immunohistochemical staining area >75.73% and Galectin-3 >82.53% are related risk factors of PCT-HT. Therefore, in clinical practice, pathological examination of thyroid papillary carcinoma can be taken in time for patients with Hashimoto's thyroiditis with positive expression of CK19 and Galectin-3, so as to diagnose thyroid cancer early, and take targeted treatment measures.

Key words: papillary thyroid carcinoma, hashimoto's thyroiditis;, CK19, Galectin-3

中图分类号:

R736.1

高丹, 吴影, 付雪莲, 李淑莲, 李化敏, 董祥梅, 付瑶. CK19及Galectin-3在甲状腺乳头状癌合并桥本氏甲状腺炎的表达及临床意义[J]. 中华养生保健, 2022, 40(21): 40-43.

GAO Dan, WU Ying, FU Xue-lian, LI Shu-lian, LI Hua-min, DONG Xiang-mei, FU Yao. Expression and clinical significance of CK19 and galectin-3 in thyroid papillary carcinoma complicated with Hashimoto's thyroiditis[J]. ZHONGHUA YANGSHENG BAOJIAN, 2022, 40(21): 40-43.

参考文献

[1] 王冰,郗洪庆,万政,等.单中心9662例甲状腺癌流行病学特征及临床病理特征分析[J].中华内分泌外科杂志,2021,15(4):342-347.
[2] Tam A A, Ince N, H Baser, et al. Enemy Beyond the Wall: Clinicopathological Features of Intrathyroidal Papillary Thyroid Carcinoma (T1-T3a) That Metastasize to Lymph Nodes Without Extrathyroidal Extension[J]. Cancer Investigation, 2021, 39(5):1-19.
[3] 周余,程若川,李想.合并桥本氏甲状腺炎对甲状腺乳头状癌临床侵袭性影响的回顾性分析[J].中华内分泌外科杂志,2022,16(1):41-44.
[4] 伏桂明,王朝晖,陈义波,等.甲状腺微小乳头状癌合并桥本氏甲状腺炎的临床特点及CLNM危险因素分析[J].中华内分泌外科杂志,2020,14(4):274-278.
[5] 刘平. 超声对桥本甲状腺炎合并甲状腺乳头状癌的诊断价值[J].中国卫生标准管理,2020,11(5):111-113.
[6] 张莹,李文华,梁越,等.HPV B19、TLR3及NF-κB在桥本氏甲状腺炎合并甲状腺乳头状癌中的表达及相关性研究[J].临床研究,2020,28(10):7-10.
[7] 韦伟,李朋.2019年第一版NCCN甲状腺恶性肿瘤治疗指南解读[J].临床外科杂志,2020,28(1):31-34.
[8] Alharbi S F, Abba A A, Hafiz A A, et al.A case of papillary hyperplasia of thyroid misdiagnosed as papillary thyroid carcinoma: Case report and review of literature[J]. Clinical Case Reports, 2021, 9(11):1-5.
[9] 李晨,田文,夏绍友,等.PCT-HT右侧喉返神经深层淋巴结转移情况分析[J].解剖学杂志,2021,44(4):326-331.
[10] 孟凡萍,郝坡,范慧.甲状腺乳头状癌并发桥本氏甲状腺炎患者BRAF-V600E基因表达及T淋巴细胞亚群分析[J].现代检验医学杂志,2020,35(1):32-34,48.
[11] 孔桂莲,孙永敏,张振华,等.血清血管内皮生长因子诊断乳头状甲状腺癌的价值[J].中华实用诊断与治疗杂志,2020,34(7):693-695.
[12] 乌云图,金山,刘友胜,等.中央区淋巴结转移强度对甲状腺乳头状癌颈侧区淋巴结转移的临床意义[J].中华内分泌外科杂志,2021,15(1):41-46.
[13] 周艳,罗枫,伍世钢,等.TPO、HBME-1、CK19、Galectin-3、CyclinD1检测在甲状腺良恶性病变中的鉴别诊断价值[J].海南医学,2020,31(1): 113-117.
[14] 周宁,许婷婷,王帆荣,等.细针穿刺细胞块石蜡包埋切片技术联合CK19、CD56、Galectin-3、BME-1检测在甲状腺结节诊断中的临床意义[J].检验医学与临床,2021,18(19):2799-2802.
[15] 张永生,王萍萍,高萍,等.免疫组化技术在甲状腺液基细胞学诊断为Ⅲ类-意义不明确细胞非典型病变中的应用价值[J].现代肿瘤医学,2021,29(11):1875-1879.
[16] 谭凤梅,郭涛,王燕,等.包膜内浸润并有乳头状癌核特点的甲状腺滤泡性肿瘤3例临床病理观察[J].诊断病理学杂志,2020,27(7):489-491.
[17] 杨柳,戴明,方杏华.下调Galectin-3对肺癌H460细胞生长及NF-κB信号通路和细胞免疫因子的影响[J].中国免疫学杂志,2020, 36(8):960-964,970.
[18] 唐丽娜,刘娜香,刘辉,等.超声剪切波弹性成像联合BRAF V600E、Galectin-3预测甲状腺结节良恶性的价值[J].中国医学影像学杂志,2021,29(1):4-8.
[19] 韩志蓉,奉泽锦,韩亮.E-cadherin和CK19表达与甲状腺乳头状癌患者临床病理特征和复发的关系[J].现代肿瘤医学,2021,29(2):220-224.
[20] 黄力营,林清群,凌雪君,等.CD56、Galectin-3、CK19及HBME-1蛋白在诊断甲状腺乳头状微小癌和非典型滤泡上皮增生中的价值[J].广东医学,2021,42(10):1188-1192.