Süren Dinç, Yildirim Mustafa, Sayiner Alper, Alikanoğlu Arsenal Sezgin, Atalay Irem, Gündüz Umut Riza, Kaya Vildan, Gündüz Şeyda, Oruç Mehmet Tahir, Sezer Cem
Department of Pathology, University of Health Sciences, Antalya Education and Research Hospital, Antalya 07050, Turkey.
Department of Medical Oncology, Medical Park Hospital, Gaziantep 27100, Turkey.
Oncol Lett. 2017 May;13(5):3722-3726. doi: 10.3892/ol.2017.5916. Epub 2017 Mar 27.
The distinction of thyroid carcinoma from benign thyroid neoplasm, as well as the subtyping of papillary carcinoma (PC) and follicular carcinoma (FC), may be performed histopathologically in the majority of cases. However, in certain cases, it is difficult to histopathologically distinguish between PC and FC, as well as follicular adenoma (FA), FC and the dominant nodule of multinodular goiter (MNG-DN). The present study aimed to determine the roles of the expression levels of the tight junction proteins claudin 1, 4 and 7 in the differential diagnosis of PC, FC, FA, MNG-DN, medullary carcinoma (MC) and anaplastic carcinoma (AC). The current study included 114 cases of histopathologically diagnosed thyroid neoplasia, which were distributed as follows: 29 FA, 18 MNG-DN, 47 PC, 10 FC, 5 MC and 5 AC. The expression levels of claudin 1, 4 and 7 were examined using immunohistochemical methods. The results revealed a significant difference in claudin 1 expression between malignant and benign thyroid neoplasms (P<0.001). Claudin 1 expression was not detected in any of the MNG-DN cases, and no significant difference in claudin 1 expression levels was identified between FA and FC (P=0.653). However, a statistically significant difference was observed between FC and PC (P<0.001). Claudin 4 expression did not differ between malignant and benign thyroid neoplasms, neither between MNG-DN, FA and FC, nor between FC and PC (P=0.068, P=0.502 and P=0.481, respectively). Claudin 7 exhibited positive immunohistochemical staining in 107 patients (94%); however, no significant difference in claudin 7 expression §levels was identified between malignant and benign thyroid neoplasms among MNG-DN, FA and FC (malignant, P=0.135; benign, P=0.470). Claudin 7 exhibited positive staining in all PC and FC cases. Therefore, claudin 1 expression levels may be useful in distinguishing cases of FC and PC with overlapping histopathological features, and provide a novel immunohistochemical marker for the subtyping of thyroid carcinoma.
在大多数情况下，甲状腺癌与良性甲状腺肿瘤的区分以及乳头状癌（PC）和滤泡状癌（FC）的亚型分类可通过组织病理学方法进行。然而，在某些情况下，很难通过组织病理学区分PC和FC，以及滤泡性腺瘤（FA）、FC和多结节性甲状腺肿的优势结节（MNG-DN）。本研究旨在确定紧密连接蛋白claudin 1、4和7的表达水平在PC、FC、FA、MNG-DN、髓样癌（MC）和未分化癌（AC）鉴别诊断中的作用。本研究纳入了114例经组织病理学诊断的甲状腺肿瘤病例，分布如下：29例FA、18例MNG-DN、47例PC、10例FC、5例MC和5例AC。采用免疫组织化学方法检测claudin 1、4和7的表达水平。结果显示，恶性和良性甲状腺肿瘤之间claudin 1表达存在显著差异（P<0.001）。在任何MNG-DN病例中均未检测到claudin 1表达，FA和FC之间claudin 1表达水平无显著差异（P=0.653）。然而，FC和PC之间观察到统计学显著差异（P<0.001）。claudin 4表达在恶性和良性甲状腺肿瘤之间、MNG-DN、FA和FC之间以及FC和PC之间均无差异（分别为P=0.068、P=0.502和P=0.481）。claudin 7在107例患者（94%）中表现为免疫组织化学阳性染色；然而，在MNG-DN、FA和FC中，恶性和良性甲状腺肿瘤之间claudin 7表达水平无显著差异（恶性，P=0.135；良性，P=0.470）。claudin 7在所有PC和FC病例中均表现为阳性染色。因此，claudin 1表达水平可能有助于区分具有重叠组织病理学特征的FC和PC病例，并为甲状腺癌的亚型分类提供一种新的免疫组织化学标志物。
