Mai K T, Bokhary R, Yazdi H M, Thomas J, Commons A S
Division of Anatomical Pathology, Department of Laboratory Medicine, The Ottawa Hospital-Civic Campus, Ontario, Canada.
Histopathology. 2002 Feb;40(2):133-42. doi: 10.1046/j.1365-2559.2002.01315.x.
We have recently observed that Hürthle cell tumours and papillary thyroid carcinoma with tumour cells showing decapitation of luminal portion of the cytoplasm (apocrine-like changes) display negative or decreased immunoreactivity for HBME. The purpose of this study is to correlate papillary thyroid carcinoma with positive and negative immunoreactivity for HBME with the histopathological features.
Two hundred and five thyroid neoplasms including carcinoma and adenomas were grouped into Hürthle cell tumours, tumours with or without some features of Hürthle cells, tumours with apocrine-like changes and adenomas with or without limited nuclear features of papillary thyroid carcinoma but not diagnostic for papillary thyroid carcinoma. All neoplasms were submitted for immunostaining with cytokeratin 19 (CK19) and HBME. Papillary thyroid carcinoma, follicular carcinoma and follicular adenoma that have areas of limited nuclear features but not diagnostic for papillary thyroid carcinoma showed stronger immunostaining for HBME than their respective counterparts with Hürthle cell changes. All Hürthle cell tumours showed negative to focal reactivity. This decrease of reactivity for HBME was proportional to the levels of Hürthle cell changes. In addition, focal to extensive apocrine-like changes were seen in most Hürthle cell neoplasms and rarely seen in non-Hürthle cell neoplasms. Apocrine-like changes abolished or decreased HBME immunoreactivity of papillary thyroid carcinoma and tumours with limited nuclear features. Immunostaining for cytokeratin AE3 was not affected by Hürthle cell or apocrine-like changes.
All papillary thyroid carcinomas without Hürthle cell or apocrine-like differentiation are reactive for HBME. Hürthle cell tumours and tumours with Hürthle cell or apocrine-like changes show negative or focal reactivity for HBME. Except for this limitation, HBME is a sensitive marker for papillary thyroid carcinoma and tumours with limited nuclear features.
我们最近观察到，许特耳细胞肿瘤和甲状腺乳头状癌中肿瘤细胞出现细胞质腔面部分断头现象（顶泌汗腺样改变）时，对HBME的免疫反应性呈阴性或降低。本研究的目的是将甲状腺乳头状癌对HBME免疫反应性的阳性和阴性与组织病理学特征相关联。
205例甲状腺肿瘤，包括癌和腺瘤，被分为许特耳细胞肿瘤、具有或不具有许特耳细胞某些特征的肿瘤、具有顶泌汗腺样改变的肿瘤以及具有或不具有甲状腺乳头状癌有限核特征但不能诊断为甲状腺乳头状癌的腺瘤。所有肿瘤均进行细胞角蛋白19（CK19）和HBME免疫染色。具有有限核特征但不能诊断为甲状腺乳头状癌的甲状腺乳头状癌、滤泡癌和滤泡性腺瘤对HBME的免疫染色比具有许特耳细胞改变的相应肿瘤更强。所有许特耳细胞肿瘤均显示阴性至局灶性反应性。HBME反应性的这种降低与许特耳细胞改变的程度成正比。此外，大多数许特耳细胞肿瘤可见局灶性至广泛的顶泌汗腺样改变，而非许特耳细胞肿瘤中很少见。顶泌汗腺样改变消除或降低了甲状腺乳头状癌和具有有限核特征肿瘤的HBME免疫反应性。细胞角蛋白AE3的免疫染色不受许特耳细胞或顶泌汗腺样改变的影响。
所有无许特耳细胞或顶泌汗腺样分化的甲状腺乳头状癌对HBME均有反应。许特耳细胞肿瘤以及具有许特耳细胞或顶泌汗腺样改变的肿瘤对HBME显示阴性或局灶性反应性。除了这一局限性外，HBME是甲状腺乳头状癌和具有有限核特征肿瘤的敏感标志物。
