Cornianu Marioara, Stan V, Lazăr Elena, Dema Alis, Golu Ioana, Tăban Sorina, Vlad Mihaela, Faur Alexandra, Vărcuş F, Babău F
Department of Pathology, Victor BabesUniversity of Medicine and Pharmacy, Timisoara, Romania.
Rom J Morphol Embryol. 2011;52(2):545-53.
Thyroid follicular adenomas (FA) and adenomatous thyroid nodules (AN) - lesions that are frequently found in areas with iodine deficiency, can be normo-/hypofunctioning (scintigraphically cold - SCN) or hyperfunctioning (scintigraphically hot - SHN) nodules.
Evaluation of proliferation potential in thyroid nodules on tissue samples obtained at surgery from euthyroid patients clinically diagnosed with SCN and from patients with thyroid hyperfunction and SHN.
We investigated the proliferation activity estimated by assessing PCNA and Ki-67 proliferation markers in 20 SCN (eight FA and 12 AN) and 16 toxic nodules (six hyperfunctioning FA and 10 toxic multinodular goiters), on formalin-fixed and paraffin-embedded tissue samples, 4-5 μm thick; we used the immunohistochemical technique in LSAB system (DAB visualization) with anti-PCNA (PC10) and anti-Ki-67 (MIB-1) monoclonal antibodies. For each case, we calculated the proliferation index PI-PCNA and PI-Ki-67. The dates were statistically evaluated using the t-unpaired test.
We observed a higher PI-PCNA in thyroid nodules than in the normal surrounding thyroid tissue, with statistically significant values for FA (14.3% vs. 3.8%; p<0.029) and also for AN (8.36% vs. 1.24%; p<0.001). The mean PI-Ki-67 in nodules vs. surrounding thyroid tissue was 1.64% vs. 1.10% in FA (p<0.35) and 1.07% vs. 0.51% in AN (p>0.05). We also noted: (1) significantly higher PI-PCNA values (p < 0.01) in FA (14.03%) than in AN (8.36%), as compared to statistically insignificant values for Ki-67 (1.64% vs. 1.07%; p>0.05); (2) increased proliferation rate (p<0.01) in thyroid nodules with aspects of lymphocytic thyroiditis (LT) (PI-Ki-67 was 1.21%) as compared to nodules without LT (PI-Ki-67 was 0.12%); (3) a mean PI-PCNA of 8.5% and PI-Ki-67 of 4.61% in toxic thyroid nodules (TTN) vs. 3.01% and 1.5% in normal surrounding thyroid, respectively.
The clinical expression of SCN is the consequence of increased thyrocyte proliferation in the nodules; the increased proliferative potential of TTN thyrocytes is a common feature of nodules, independent of their histopathological characteristics.
甲状腺滤泡性腺瘤（FA）和腺瘤性甲状腺结节（AN）——在碘缺乏地区常见的病变，可为功能正常/功能减退（闪烁扫描显示为冷结节 - SCN）或功能亢进（闪烁扫描显示为热结节 - SHN）结节。
评估在手术中从临床诊断为SCN的甲状腺功能正常患者以及甲状腺功能亢进和SHN患者获取的组织样本中甲状腺结节的增殖潜能。
我们通过评估PCNA和Ki-67增殖标志物来研究20个SCN（8个FA和12个AN）以及16个毒性结节（6个功能亢进性FA和10个毒性多结节性甲状腺肿）的增殖活性，样本为4 - 5μm厚的福尔马林固定石蜡包埋组织；我们在LSAB系统中使用免疫组织化学技术（DAB显色），采用抗PCNA（PC10）和抗Ki-67（MIB-1）单克隆抗体。对于每个病例，我们计算增殖指数PI-PCNA和PI-Ki-67。数据采用非配对t检验进行统计学评估。
我们观察到甲状腺结节中的PI-PCNA高于周围正常甲状腺组织，FA（14.3%对3.8%；p<0.029）和AN（8.36%对1.24%；p<0.001）的差异具有统计学意义。结节与周围甲状腺组织的平均PI-Ki-67在FA中为1.64%对1.10%（p<0.35），在AN中为1.07%对0.51%（p>0.05）。我们还注意到：（1）FA中的PI-PCNA值（14.03%）显著高于AN（8.36%）（p < （此处原文似乎有误，推测为p < 0.01）），而Ki-67值差异无统计学意义（1.64%对1.07%；p>0.05）；（2）与无淋巴细胞性甲状腺炎（LT）的结节（PI-Ki-67为0.12%）相比，具有淋巴细胞性甲状腺炎（LT）表现的甲状腺结节增殖率增加（p<0.01）（PI-Ki-67为1.21%）；（3）毒性甲状腺结节（TTN）的平均PI-PCNA为8.5%，PI-Ki-67为4.61%，而周围正常甲状腺分别为3.01%和1.5%。
SCN的临床表型是结节中甲状腺细胞增殖增加的结果；TTN甲状腺细胞增殖潜能增加是结节的共同特征，与其组织病理学特征无关。
