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[甲状腺良性和恶性滤泡性肿瘤的核大小及核仁组成区特征]

[Nuclear size and character of the nucleolar organizer in benign and malignant follicular tumors of the thyroid gland].

作者信息

Dusková J

机构信息

II. patologicko anatomický ústav 1. LF UK, Praha.

出版信息

Cesk Patol. 1992 Sep;28(4):201-6.

PMID:1477899
Abstract

Histologic sections of 11 benign and 11 malignant follicular tumours of the thyroid were compared from the point of view of subsequent practising cytologic diagnosis. Following features were analysed in 100 randomly chosen thyreocytic nuclei: maximal nuclear diameter, nucleolar organizer rates (AgNOR) inside and outside the nucleoli, total AgNOR according to a modified Crocker s et al. method, total nucleolar rate and maximal nucleolar diameter, proportion of maximal nucleolar diameter and maximal nuclear diameter, AgNOR in vicinal nontumorous thyreocytes. All of them except total AgNOR did not show any significant differences according to modified t-test. But the increase of total AgNOR in follicular carcinomas lost its significance in Duncan's test of variance analysis because of a high maximal nucleolar diameter regarding big figures in 4 carcinomas (2 of them oxyphilic celled). In most tumours AgNOR inside nucleoli could not be reliably distinguished and quantified even after shortening of silver impregnation. Mean maximal nuclear diameter bigger than 7 nm, indicating malignant follicular lesion according to literature, could not be verified in 8 tumours- it was smaller in 5 carcinomas and bigger in 3 benign tumours. Proportion of maximal nucleolar diameter and maximal nuclear diameter was stable in benign and malignant tumours as well as the AgNOR in peritumorous thyreocytes. All the analysed nuclear features are lacking in sufficient prediction value for distinction of benign and malignant follicular tumours of the thyroid.

摘要

从后续实施细胞诊断的角度,对11例甲状腺良性滤泡性肿瘤和11例恶性滤泡性肿瘤的组织学切片进行了比较。在随机选择的100个甲状腺细胞核中分析了以下特征:最大核直径、核仁内外的核仁组织区率(AgNOR)、根据改良的克罗克等人的方法计算的总AgNOR、总结率和最大核仁直径、最大核仁直径与最大核直径的比例、邻近非肿瘤性甲状腺细胞中的AgNOR。除总AgNOR外,所有这些特征经改良t检验均未显示出任何显著差异。但在方差分析的邓肯检验中,滤泡癌中总AgNOR的增加失去了显著性,因为4例癌(其中2例为嗜酸性细胞癌)中的大数字核仁直径较大。即使缩短银染时间,大多数肿瘤内核仁内的AgNOR也无法可靠区分和定量。根据文献,平均最大核直径大于7nm表明为恶性滤泡性病变,但在8例肿瘤中未得到证实——5例癌中较小,3例良性肿瘤中较大。良性和恶性肿瘤中最大核仁直径与最大核直径的比例以及肿瘤周围甲状腺细胞中的AgNOR均稳定。所有分析的核特征在区分甲状腺良性和恶性滤泡性肿瘤方面都缺乏足够的预测价值。

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