Ludvíková M, Ryska A, Hovorková E, Pikner R
Siklův patologicko-anatomický ústav FN a LF UK, Plzen.
Cesk Patol. 2002 Jan;38(1):4-10.
Well-differentiated thyroid tumors may sometimes cause diagnostic uncertainty due to difficulties in the evaluation of certain morphological criteria (capsular and/or vascular invasion, cytomorphological features). Therefore, various diagnostic/prognostic markers are currently studied, namely the markers of tumor proliferation. The aim of our study was to evaluate the proliferative MIB-1 index in 155 thyroid tumors, and to correlate it with morphological diagnosis, size of the tumors, and the patients' age. Oncocytic tumors were represented by 59 follicular adenomas, 27 follicular carcinomas and 12 papillocarcinomas. Nononcocytic tumors comprised 24 follicular adenomas and 33 conventional papillary carcinomas. The Ki-67 antigen (formalin resistant epitope MIB-1) was detected immunohistochemically and the proliferative index (PI) of tumors was evaluated. The results were statistically analyzed using analysis of variance (ANOVA) and Wilcoxon tests (significance level p < 0.05). Carcinomas showed significantly higher PI than adenomas. Moreover, PI in oncocytic adenomas was higher than in nononcocytic ones. However, proliferative activity in all types of the carcinomas was similar. The higher rates of proliferation correlated with the advanced age of the patients with follicular carcinomas (p < 0.0016).
高分化甲状腺肿瘤有时可能会因某些形态学标准(包膜和/或血管侵犯、细胞形态学特征)评估困难而导致诊断不确定性。因此,目前正在研究各种诊断/预后标志物,即肿瘤增殖标志物。我们研究的目的是评估155例甲状腺肿瘤的增殖性MIB-1指数,并将其与形态学诊断、肿瘤大小和患者年龄相关联。嗜酸性肿瘤包括59例滤泡性腺瘤、27例滤泡性癌和12例乳头状癌。非嗜酸性肿瘤包括24例滤泡性腺瘤和33例传统乳头状癌。通过免疫组织化学检测Ki-67抗原(抗甲醛表位MIB-1)并评估肿瘤的增殖指数(PI)。使用方差分析(ANOVA)和威尔科克森检验(显著性水平p < 0.05)对结果进行统计学分析。癌的PI显著高于腺瘤。此外,嗜酸性腺瘤的PI高于非嗜酸性腺瘤。然而,所有类型癌的增殖活性相似。增殖率较高与滤泡性癌患者的高龄相关(p < 0.0016)。