Pujani M, Arora B, Pujani M, Singh S K, Tejwani N
Department of Pathology, Pt. B D Sharma PGIMS, Rohtak, India.
Indian J Cancer. 2010 Jul-Sep;47(3):304-7. doi: 10.4103/0019-509X.64727.
Specific criteria are used to diagnose thyroid neoplasms; however, the distinction between certain neoplasms, such as follicular adenoma and carcinoma, could be difficult. Thus, additional diagnostic features that can assist in this distinction would have great clinical usefulness.
To evaluate the role of the proliferative marker Ki-67 in nonneoplastic and neoplastic lesions of the thyroid, with a special emphasis on the distinction between follicular adenoma and follicular carcinoma.
A retrospective study from a tertiary care center.
One hundred cases of thyroid lesions, including 50 nonneoplastic and 50 neoplastic lesions, were retrieved from the archives of the Department of Pathology, Pt. BD Sharma PGIMS, Rohtak, Ki-67 immunostaining was performed by peroxidase-antiperoxidase method and compared with mitotic counts.
Ki-67 labeling index (LI) showed a progressive rise from multinodular goiter to benign to malignant neoplasms. A statistically significant difference was observed in Ki-67 counts between multinodular goiter vs papillary carcinoma (P < 0.05) and follicular adenoma vs follicular carcinoma (P < 0.05). The correlation between mitotic counts and Ki-67 LI was found to be significant.
In the present study, Ki-67 was found to be useful in differentiating between follicular adenoma and follicular carcinoma, but since the sample size of our study was small, larger studies are needed to confirm this observation as well as to assign a cutoff value for differentiating benign from malignant tumors.
特定标准用于诊断甲状腺肿瘤;然而,某些肿瘤之间的区分,如滤泡性腺瘤和癌,可能会很困难。因此,有助于这种区分的额外诊断特征将具有很大的临床实用性。
评估增殖标志物Ki-67在甲状腺非肿瘤性和肿瘤性病变中的作用,特别强调滤泡性腺瘤和滤泡性癌之间的区分。
一项来自三级医疗中心的回顾性研究。
从罗塔克市Pt. BD Sharma PGIMS病理学系档案中检索100例甲状腺病变,包括50例非肿瘤性病变和50例肿瘤性病变,采用过氧化物酶-抗过氧化物酶法进行Ki-67免疫染色,并与有丝分裂计数进行比较。
Ki-67标记指数(LI)显示从多结节性甲状腺肿到良性肿瘤再到恶性肿瘤呈逐渐上升趋势。多结节性甲状腺肿与乳头状癌之间以及滤泡性腺瘤与滤泡性癌之间的Ki-67计数存在统计学显著差异(P < 0.05)。有丝分裂计数与Ki-67 LI之间的相关性显著。
在本研究中,发现Ki-67有助于区分滤泡性腺瘤和滤泡性癌,但由于本研究的样本量较小,需要更大规模的研究来证实这一观察结果,并确定区分良性与恶性肿瘤的临界值。