Kanthan R, Radhi J M
Department of Pathology, Royal University Hospital, University of Saskatchewan, Saskatoon, Canada.
Pathology. 1998 Feb;30(1):4-6. doi: 10.1080/00313029800169575.
Twenty-five cases of thyroid adenomas with Hurthle cell changes, both pure and focal, were studied histologically and immunohistochemically with two objectives: first to elucidate the relationship between the normal uninvolved thyroid and the adenoma; and second, to evaluate the role of immunohistochemical studies in adenomas with Hurthle cell changes. Representative sections were stained with a panel of nine antibodies directed against thyroglobulin (TG), high molecular weight keratin (HMK), low molecular weight keratin (LMK), p53, bcl-2, epithelial membrane antigen (EMA), S100, carcinoembryonic antigen (CEA) and HMB45. In all cases, uniform strong positive staining (+3) with TG and bcl-2 was seen in the normal thyroid tissue while the adenoma stained moderately positive (+2). The reverse pattern was observed with LMK staining. Non-adenomatous thyroid cells were p53-negative, the majority of the Hurthle cells, however, were p53-positive and adenomas with an increased number of Hurthle cells had an increased percentage of p53 staining. The expression of EMA was variable. All thyroid cells both outside and within the adenoma were S100-, CEA-4 and HMB45-negative in all cases. The exact significance of p53 overexpression in the Hurthle cells needs further evaluation.
对25例伴有许特莱细胞改变（包括单纯性和局灶性）的甲状腺腺瘤进行了组织学和免疫组织化学研究，目的有两个：一是阐明未受累的正常甲状腺与腺瘤之间的关系；二是评估免疫组织化学研究在伴有许特莱细胞改变的腺瘤中的作用。代表性切片用一组9种抗体染色，这些抗体分别针对甲状腺球蛋白（TG）、高分子量角蛋白（HMK）、低分子量角蛋白（LMK）、p53、bcl-2、上皮膜抗原（EMA）、S100、癌胚抗原（CEA）和HMB45。在所有病例中，正常甲状腺组织中TG和bcl-2呈均匀强阳性染色（+3），而腺瘤呈中度阳性染色（+2）。LMK染色则观察到相反的模式。非腺瘤性甲状腺细胞p53阴性，然而，大多数许特莱细胞p53阳性，且许特莱细胞数量增加的腺瘤p53染色百分比增加。EMA的表达是可变的。在所有病例中，腺瘤内外的所有甲状腺细胞S100、CEA和HMB45均为阴性。许特莱细胞中p53过表达的确切意义需要进一步评估。
