Gupta Ashumi, Jain Shyama, Khurana Nita, Kakar Arun Kumar
Assistant Professor, Department of Pathology, Baba Saheb Ambedkar Medical College and Hospital , New Delhi, India .
Professor and Head of the Department, Department of Pathology, Maulana Azad Medical College , New Delhi, India .
J Clin Diagn Res. 2016 Jul;10(7):EC04-8. doi: 10.7860/JCDR/2016/13899.8157. Epub 2016 Jul 1.
Bcl-2 is a marker recently studied in thyroid tumours and proposed to have prognostic significance. p63 is expressed in a proportion of papillary thyroid carcinoma cases and may have a role in tumour progression.
To study expression of Bcl2 and p63 in thyroid tumours and correlation of Bcl-2 with diagnostic markers including Thyroglobulin, Calcitonin and Carcinoembryonic antigen.
Cytology smears of 35 cases of thyroid cancer were studied over a period of 18 months. In 20 cases histopathology was available. Immunocytochemistry for Bcl-2 and p63 was done, and diagnostic markers were applied as and when required.
p63 showed focal nuclear expression in 46.1% of papillary thyroid carcinoma cases, and was negative in all other tumours. Bcl-2 was positive in 88.9% of follicular carcinomas, 100% of papillary carcinomas and 83.3% of medullary carcinoma cases, and showed focal weak expression in 40% of Anaplastic Carcinoma (ATC) cases, thereby signifying down regulation (p-value = 0.001). There was significant down regulation of Thyroglobulin (Tg) in ATC vs well differentiated follicular derived tumours (p-value ≤ 0.016). Positive correlation was noted between expression of Bcl-2 and Calcitonin (0.93) and Bcl-2 and Carcinoembryonic Antigen (CEA) (0.89), and weak positive correlation (0.65) between Tg and Bcl-2.
Bcl-2 is downregulated in anaplastic carcinomas as compared to well differentiated thyroid tumours, and shows correlation with differentiation associated tumour antigens. Thus, loss of Bcl-2 was associated with loss of differentiation in thyroid tumours. Anaplastic carcinoma as such is associated with worse prognosis and loss of Bcl-2 may be partly responsible for the same. p63 is specific but less sensitive marker for PTC. Further studies are required to determine the role of Bcl-2 and p63 in thyroid tumours.
Bcl-2是一种最近在甲状腺肿瘤中进行研究的标志物，并被认为具有预后意义。p63在一部分甲状腺乳头状癌病例中表达，可能在肿瘤进展中发挥作用。
研究Bcl-2和p63在甲状腺肿瘤中的表达情况，以及Bcl-2与包括甲状腺球蛋白、降钙素和癌胚抗原在内的诊断标志物之间的相关性。
在18个月的时间里对35例甲状腺癌的细胞学涂片进行了研究。其中20例有组织病理学资料。进行了Bcl-2和p63的免疫细胞化学检测，并在需要时应用诊断标志物。
p63在46.1%的甲状腺乳头状癌病例中呈局灶性核表达，在所有其他肿瘤中均为阴性。Bcl-2在88.9%的滤泡癌、100%的乳头状癌和83.3%的髓样癌病例中呈阳性，在40%的间变性癌（ATC）病例中呈局灶性弱表达，从而表明其下调（p值 = 0.001）。与高分化滤泡性来源肿瘤相比，ATC中间甲状腺球蛋白（Tg）有显著下调（p值≤0.016）。观察到Bcl-2与降钙素（0.93）以及Bcl-2与癌胚抗原（CEA）（0.89）之间呈正相关，Tg与Bcl-2之间呈弱正相关（0.65）。
与高分化甲状腺肿瘤相比，间变性癌中Bcl-2下调，并与分化相关的肿瘤抗原显示出相关性。因此，甲状腺肿瘤中Bcl-2的缺失与分化丧失有关。间变性癌本身与预后较差相关，Bcl-2的缺失可能部分与此有关。p63是甲状腺乳头状癌的特异性但不太敏感的标志物。需要进一步研究以确定Bcl-2和p63在甲状腺肿瘤中的作用。
