Cameron Billie-Rose, Berean Kenneth W
Division of Otolaryngology, Vancouver General Hospital, University of British Columbia.
J Otolaryngol. 2003 Oct;32(5):319-22. doi: 10.2310/7070.2003.11429.
The follicular variant of papillary thyroid carcinoma (FV-PTC) may be difficult to differentiate from other thyroid neoplasms with follicular architecture such as follicular adenoma, follicular carcinoma, and dominant nodules in nodular goitre. Obvious differences in treatment and expected outcome between these lesions mandate that the distinction between them be made accurately. To decrease the subjectivity of this differential diagnosis, we undertook this study to determine if any difference in cytokeratin profile exists between FV-PTC and other follicular lesions of the thyroid gland.
Immunohistochemical analysis based on a retrospective pathology review.
Vancouver General Hospital, Vancouver, BC.
The files of the Vancouver General Hospital anatomic pathology laboratory were searched for cases of typical papillary thyroid carcinoma (PTC), FV-PTC, follicular adenoma, follicular carcinoma, and nodular goitre. The slides and reports were reviewed, and those cases with confirmed diagnosis and adequate tissue were selected for inclusion in the study. Monoclonal antibodies to cytokeratin 19 (CK19), 20 (CK20), and 7 (CK7) were applied to formalin-fixed, paraffin-embedded tissue sections.
All cases of PTC, including FV-PTC, as well as all follicular adenomas, follicular carcinomas, and nodular goitres, stained positively for CK7 and, except for a single follicular carcinoma, were negative for CK20. CK19 decorated almost all PTCs, including FV-PTC, although the staining was sometimes focal. The majority of the cases of follicular adenoma, follicular carcinoma, and nodular goitre were negative or showed focal staining with CK19, although occasional cases showed diffuse positivity.
CK19 strongly stains the majority of PTC, including FV-PTC, in a diffuse manner. However, overlap with the staining seen in other follicular lesions limits its utility in a routine diagnostic setting.
甲状腺乳头状癌滤泡型（FV-PTC）可能难以与其他具有滤泡结构的甲状腺肿瘤相鉴别，如滤泡性腺瘤、滤泡癌和结节性甲状腺肿中的优势结节。这些病变在治疗和预期结果上存在明显差异，因此必须准确区分它们。为了减少这种鉴别诊断的主观性，我们开展了这项研究，以确定FV-PTC与甲状腺其他滤泡性病变之间在细胞角蛋白谱上是否存在差异。
基于回顾性病理检查的免疫组织化学分析。
不列颠哥伦比亚省温哥华市温哥华总医院。
检索温哥华总医院解剖病理实验室的档案，查找典型甲状腺乳头状癌（PTC）、FV-PTC、滤泡性腺瘤、滤泡癌和结节性甲状腺肿的病例。对切片和报告进行复查，选择诊断明确且组织充足的病例纳入研究。将细胞角蛋白19（CK19）、20（CK20）和7（CK7）的单克隆抗体应用于福尔马林固定、石蜡包埋的组织切片。
所有PTC病例，包括FV-PTC，以及所有滤泡性腺瘤、滤泡癌和结节性甲状腺肿，CK7染色均为阳性，除1例滤泡癌外，CK20染色均为阴性。CK19几乎标记了所有PTC病例，包括FV-PTC，尽管有时染色呈局灶性。大多数滤泡性腺瘤、滤泡癌和结节性甲状腺肿病例CK19染色为阴性或呈局灶性染色，尽管偶尔有病例呈弥漫性阳性。
CK19以弥漫性方式强烈标记大多数PTC，包括FV-PTC。然而，与其他滤泡性病变的染色重叠限制了其在常规诊断中的应用。
