Hashimoto Katsunori, Morimoto Ayumi, Kato Makoto, Tominaga Yoshihiro, Maeda Nagako, Tsuzuki Toyonori, Yokoi Toyoharu, Nagasaka Tetsuro
Department of Medical Technology, Nagoya University School of Health Sciences, Nagoya, Japan.
Nagoya J Med Sci. 2011 Feb;73(1-2):15-24.
Recently, liquid-based cytology (LBC) has been widely applied to various samples in diagnostic cytology and its usefulness has been reported. In this study, we investigated thyroid cytology that applied LBC and immunocytochemistry to achieve more objective diagnosis and greater diagnostic accuracy. This study included 125 cases (57 papillary carcinomas (PCs), 22 follicular tumors, 43 adenomatous goiters and 3 with Basedow's disease). After preparing the LBC slide, immunocytochemical staining was performed on each slide with six antibodies (HBME-1, cytokeratin 19 (CK19), high molecular weight cytokeratin (34JE12), galectin-3, CD15 and CA 19-9). All antibodies presented immunopositivity frequently in PCs, but only a few or some of them were positive in other cases. These antibodies were considered positive markers for PCs, and the most reliable marker was 34betaE12; its sensitivity, specificity and diagnostic accuracy were 82.5%, 100% and 92.0%, respectively. Relations of immunocytochemical profiles against these markers were assessed using panel 34betaE12, GAL-3 and CK19. More than or equal to two of these markers showed co-positive in 53 of 57 PCs, and negative for all markers was observed in only one case. In the other (non PC) cases, the former was 0 of 58 and the latter was 40 cases. In this panel, the sensitivity, specificity and diagnostic accuracy were 93.0%, 100% and 96.8%, respectively. All of these values were higher than or equal to single values of 34betaE12. We concluded that the panel in this study is useful for more objective and accurate diagnosis of thyroid cytology.
近年来，液基细胞学（LBC）已广泛应用于诊断细胞学的各种样本，其效用也已有报道。在本研究中，我们探讨了应用LBC和免疫细胞化学的甲状腺细胞学，以实现更客观的诊断和更高的诊断准确性。本研究纳入了125例病例（57例乳头状癌（PC）、22例滤泡性肿瘤、43例腺瘤性甲状腺肿和3例伴有巴塞多氏病）。制备LBC玻片后，用六种抗体（HBME-1、细胞角蛋白19（CK19）、高分子量细胞角蛋白（34JE12）、半乳糖凝集素-3、CD15和CA 19-9）对每张玻片进行免疫细胞化学染色。所有抗体在PC中均频繁呈现免疫阳性，但在其他病例中只有少数或部分呈阳性。这些抗体被认为是PC的阳性标志物，最可靠的标志物是34βE12；其敏感性、特异性和诊断准确性分别为82.5%、100%和92.0%。使用34βE12、GAL-3和CK19组合评估针对这些标志物的免疫细胞化学图谱关系。在57例PC中，53例有两种或两种以上这些标志物呈共同阳性，仅1例所有标志物均为阴性。在其他（非PC）病例中，前者在58例中为0例，后者为40例。在该组合中，敏感性、特异性和诊断准确性分别为93.0%、100%和96.8%。所有这些值均高于或等于34βE12的单个值。我们得出结论，本研究中的组合有助于更客观准确地诊断甲状腺细胞学。
