【摘要】 目的探讨甲状腺微小乳头状癌(PTM)及其相关疾病的诊断与鉴别诊断。方法收集PTM32例,结节性甲状腺肿伴乳头状增生14例。对以上病例进行临床和病理组织形态观察、免疫组化标记,并复习相关文献。结果 PTM以乳头状结构形成为最重要特征,可出现毛玻璃核、核异型、重叠、包涵体等细胞核特征,而结节性甲状腺肿伴乳头状增生的乳头结构一般不伴有以上细胞核特征,也不会出现间质硬化及浸润。免疫组化显示CK19、Galectin-3和HBME-1在PTM和甲状腺乳头状增生中的强阳性率差异有统计学意义(P<0.01)。结论 PTM与其相关疾病的鉴别主要基于其细胞核形态和生长方式,CK19、Galectin-3和HBME-1的强阳性表达是鉴别PTM和乳头状增生很有意义的指标。更多还原

【Abstract】 Objective To investigate the way of diagnosis and differential diagnosis of the papillary thyroid microcarcinoma(PTM)and the related diseases.Methods Thirty-two cases of PTM and 14 cases of papillary hyperplasia were observed respectively with their clinical findings,histopathology and immunohistochemical staining.Results The papillary structures were the most important features of PTM such as ground-glass nuclei,nuclear atypia and overlapping may observed,but these features were not found in the papillary hyperplastic disease.Immunohistochemical expression of CK19、Galectin-3 and HBME-1in groups of PTM and papillary hyperplasia had statistical significance(P<0.01).Conclusions The diagnosis and differential diagnosis of PTM and the related diseases are based on their growth patterns and nuclear features.The diffuse,moderate to strong positive expression pattern of CK19、Galectin-3 and HBME-1 is very useful for differential diagnosis between PTM and papillary hyperplasia.更多还原