【摘要】 目的:探讨甲状腺髓样癌(MTC)的临床病理特点、免疫表型及电镜诊断特点。方法:回顾性分析10例甲状腺髓样癌的临床资料,采用免疫组化、组织化学方法研究其病理形态特点,结合文献分析甲状腺髓样癌的电镜诊断特点。结果:散发型甲状腺髓样癌8例,家族型甲状腺髓样癌2例,6例淋巴结转移;9例肿瘤间质刚果红染色(+);免疫组化:癌组织中降钙素(+)10例、铬粒素A(+)10例、突触素(+)7例,1例见甲状腺球蛋白阳性细胞,CD44V6在髓样癌中的阳性表达率为60%;电镜下见癌细胞胞质内有大小不一的神经内分泌颗粒。结论:MTC具有多分化肿瘤的特点,可产生多种神经内分泌物质;其诊断依赖于组织病理学、免疫组化和组织化学,电镜在MTC的诊断中有重要价值;降钙素(CT)是其特异性标记物;CD44V6的高表达与MTC的颈部淋巴结转移密切相关。更多还原

【Abstract】 Objective:To investigate the clinical and pathological characteristics and immunophenotype of medullary thyroid carcinoma(MTC)and its ultrastmcmral characteristic.Methods:The clinical intormation of 10 cases MTC were retrospectively reviewed.Histochemistry and immunohistochemistry were performed to study the pathological characteristics,diagnosis of electron microscope was discussed.Results:Sporadic type of MTC was found in 8 cases,and familial type in 2 case.6 cases were observed with Lymph node metastasis;There was amyloid In the stroma of 9 cases.The immunohistochemical results showed calcitonin(CT)and CgA were positive in all cases;7 cases were positive for Syn,TG was present in 1 case,The positive rate of CD44V6 expression in MTC was 60%.The main ultrastuctural characteristic of the tumor was small and large secretory granules in the cytoplasm.Conclusions:MTC has the characteristics of multiple differentiation tumor,which can produce numerous hormones.Its diagnosis depends on its histopathology,histochemistry and immunohistochemistry.Electron microscope is of great value in the diagnosia of MTC.Calcitonin is a specific molecular marker for the diagnosis of MTC.The overexpression of CD44V6 in MTC is closely relate to the lymph node metastasis.更多还原