Department of Ultrasound, The Fourth Hospital of Hebei Medical University and Hebei Provincial Tumor Hospital, 12 Jiankang Road, Shijiazhuang, Hebei Province, 050011, People's Republic of China.
Department of Interventional Therapy, Henan Provincial People's Hospital, Zhengzhou, China.
Pathol Oncol Res. 2019 Jul;25(3):1075-1081. doi: 10.1007/s12253-018-0485-6. Epub 2018 Oct 25.
To investigate the effect of ultrasound combined with expression of Galectin-3, c-Met, HBME-1 and CK19 in differentiating malignant from benign thyroid nodules. Forty-six patients with thyroid nodules were studied with ultrasound and immunohistochemical staining of excised thyroid nodules. The data were classified and compared. The immunohistochemical staining revealed 8 benign and 41 malignant thyroid lesions. In ultrasound risk assessment, the malignancy risk was low in four nodules, medium in five and high in 37 with lymphatic metastasis in 26. A significant (P < 0.05) association existed in the expression of Galectin-3 with nodule boundary and lymphatic metastasis, in HBME-1 with nodule micro-calcification and in c-Met with nodule micro-calcification and lymphatic metastasis. CK19 expression was not significantly (P > 0.05) associated with any of ultrasound features of nodule. Galectin-3, c-Met, HBME-1 and CK19 were significantly (P < 0.05) different in malignant and benign thyroid lesions, with a significant (P < 0.01) tendency in all the molecular markers in predicting the malignant from benign lesions. The ultrasound characteristics could significantly (P < 0.001) predict malignant nodules with a significant (P < 0.05) prediction tendency. The scores of Galectin-3, c-Met and CK19 significantly (P < 0.05) increased with increase of ultrasound malignancy risk degree. In malignant and benign lesions differentiated by ultrasound, no significant (P > 0.05) difference existed in HBME-1 expression, however, with ultrasound malignancy risk increase, the score of HBME-1 expression increased significantly (P = 0.03). Galectin-3, c-Met, HBME-1 and CK19 have significantly greater expressions in thyroid malignant than benign lesions and their expression increases with increase of ultrasound malignancy risk. The combination of both ultrasound and molecular markers can be used to differentiate malignant and benign thyroid lesions.
探讨超声联合半乳糖凝集素-3（Galectin-3）、c-Met、HBME-1 和 CK19 的表达在鉴别甲状腺良恶性结节中的作用。对 46 例甲状腺结节患者进行超声检查及切除甲状腺结节的免疫组化染色，对数据进行分类比较。免疫组化染色显示 8 例良性和 41 例恶性甲状腺病变。在超声风险评估中，4 个结节的恶性风险低，5 个结节的恶性风险中，37 个结节的恶性风险高，26 个有淋巴结转移。Galectin-3 的表达与结节边界和淋巴结转移显著相关（P<0.05），HBME-1 的表达与结节微钙化显著相关，c-Met 的表达与结节微钙化和淋巴结转移显著相关（P<0.05）。CK19 的表达与结节的任何超声特征均无显著相关性（P>0.05）。Galectin-3、c-Met、HBME-1 和 CK19 在良恶性甲状腺病变中的表达差异有统计学意义（P<0.05），所有分子标志物在预测良恶性病变方面均有显著趋势（P<0.01）。超声特征能显著（P<0.001）预测恶性结节，有显著（P<0.05）的预测趋势。Galectin-3、c-Met 和 CK19 的评分随超声恶性风险程度的增加而显著增加（P<0.05）。在超声鉴别良恶性病变中，HBME-1 的表达无显著差异（P>0.05），但随着超声恶性风险的增加，HBME-1 表达的评分显著增加（P=0.03）。Galectin-3、c-Met、HBME-1 和 CK19 在甲状腺恶性病变中的表达明显高于良性病变，且表达随超声恶性风险的增加而增加。超声与分子标志物联合应用可用于鉴别甲状腺良恶性病变。
