Ma Heng, Yan Jin, Zhang Chao, Qin Shenghui, Qin Lingzhi, Liu Liwei, Wang Xi, Li Naping
Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, Hubei Province, China.
Department of ENT, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology Wuhan, Hubei Province, China.
Int J Clin Exp Pathol. 2014 Oct 15;7(11):7999-8007. eCollection 2014.
The aim of this study was to evaluate the expression of papillary thyroid carcinoma (PTC)-associated tumor markers in follicular epithelial dysplasia showing PTC-like nuclear alterations (FED) in Hashimoto's thyroiditis (HT) and to explore the relationship between HT and PTC. In this study, 43 PTC, 18 HT with FED and 16 peritumoral benign thyroid tissues were immunohistochemically analyzed for CK19, galectin-3, HBME-1, CD56, claudin-1 and NGAL expression. Our research revealed that in HT, the expression of CK19, galectin-3, HBME-1, claudin-1 and NGAL was focal and limited to FED, while CD56 was strongly positive in FED and most Hürthle cells. The stain intensity of CK19, claudin-1 and NGAL in FED decreased compared with PTC, but were significantly higher than that in peritumoral benign thyroid tissues (all P < 0.0125). For galectin-3, HBME-1 and CD56, no statistically significant difference was detected between HT and peritumoral benign thyroid tissues (all P > 0.05). In conclusion, In HT, FED might be a precancerous condition closely associated with PTC development as they have overlaps in cytological and immunomarker profiles, indicating that in patients with HT, under prolonged stimuli from chronic inflammation, part of follicular epithelia may show regeneration, hyperplasia, Hürthle cell metaplasia and dysplasia, eventually malignant transformation. Hence, long term follow-up and regular inspection would be necessary for Hashimoto's thyroiditis with FED.
本研究旨在评估桥本甲状腺炎(HT)中呈现甲状腺乳头状癌(PTC)样核改变的滤泡上皮发育异常(FED)中PTC相关肿瘤标志物的表达情况,并探讨HT与PTC之间的关系。在本研究中,对43例PTC、18例伴有FED的HT以及16例肿瘤周围良性甲状腺组织进行免疫组化分析,检测CK19、半乳糖凝集素-3、HBME-1、CD56、闭合蛋白-1和中性粒细胞明胶酶相关脂质运载蛋白(NGAL)的表达。我们的研究显示,在HT中,CK19、半乳糖凝集素-3、HBME-1、闭合蛋白-1和NGAL的表达呈局灶性,且仅限于FED,而CD56在FED和大多数许特耳细胞中呈强阳性。与PTC相比,FED中CK19、闭合蛋白-1和NGAL的染色强度降低,但显著高于肿瘤周围良性甲状腺组织(所有P<0.0125)。对于半乳糖凝集素-3、HBME-1和CD56,HT与肿瘤周围良性甲状腺组织之间未检测到统计学上的显著差异(所有P>0.05)。总之,在HT中,FED可能是与PTC发生密切相关的癌前状态,因为它们在细胞学和免疫标志物谱方面存在重叠,这表明在HT患者中,在慢性炎症的长期刺激下,部分滤泡上皮可能会出现再生、增生、许特耳细胞化生和发育异常,最终发生恶性转化。因此,对于伴有FED的桥本甲状腺炎患者,有必要进行长期随访和定期检查。