【摘要】 目的探讨CK8、CK19和甲状腺过氧化物酶(Thyroid Peroxidase,TPO)联合检测在甲状腺乳头状癌及乳头状增生病变中的诊断与鉴别诊断应用价值。方法应用免疫组织化学Eli Vision法对233例甲状腺乳头状癌和61例乳头状增生病变进行标志。结果 233例甲状腺乳头状癌CK8、CK19和TPO阳性率分别为97.0%、94.4%、9.0%;61例乳头状增生病变中阳性率分别为49.2%、26.2%、88.5%。三者在甲状腺乳头状癌与乳头状增生病变中的表达差异具有统计学意义(P<0.01)。CK8、CK19和TPO单项检测鉴别甲状腺乳头状癌与乳头状增生的敏感度、特异度和准确度分别为97.0%、50.8%、87.4%;94.4%、73.8%、90.1%和90.9%、88.5%、90.5%;阳性预测值(+PV)分别为88.3%、93.2%、96.8%;阴性预测值(-PV)分别为77.5%、77.6%、72.0%;Youden指数分别为0.478、0.682、0.794。序列试验显示,三者联合检测敏感度、特异度和Youden指数分别为83.2%、98.5%和0.817。结论 CK8、CK19和TPO可作为鉴别甲状腺乳头状癌和乳头状增生的重要标志物,三者联合检测特异性更好,具有更高的鉴别诊断价值。更多还原

【Abstract】 Objective To investigate the differential diagnostic value of combined detection of CK8,CK19 and thyroid peroxidase(TPO) in papillary thyroid carcinoma and papillary hyperplasia.Methods CK8,CK19 and TPO were detected by EliVision immunohistochemical method in tissue sections from 233 cases of papillary thyroid carcinoma and 61 cases of papillary thyroid hyperplasia.Results The positive expression rates of CK8,CK19 and TPO in 233 cases of papillary thyroid carcinoma were 97.0%,94.4 and 9.0;in 61 papillary hyperplasia lesions were 49.2%,26.2% and 88.5%,respectively.There were significant differences between papillary thyroid carcinoma and papillary hyperplasia(P<0.01).The sensibility,specificity and accuracy of CK8,CK19 and TPO in differential diagnosis of two diseases were 97.0%,50.8%,87.4%;94.4%,73.8%,90.1%;and 90.9%,88.5%,90.5%,respectively.The positive predictive values were 88.3%,93.2% and 96.8%,respectively;the negative predictive values were 77.5%,77.6% and 72.0%,respectively.The Youden indexes were 0.487,0.682 and 0.794,respectively.Serial test of combined detection of the three markers showed that the sensibility,specificity and Youden index in differential diagnosis between the two diseases were 83.2%,98.5% and 0.817,respectively.Conclusion CK8,CK19 and TPO are useful markers for differential diagnosis between papillary thyroid carcinoma and papillary hyperplasia,the specificity of combined detection of the three markers can be further improved.更多还原