【作者】 宝荣；

【导师】 周庚寅；

【作者基本信息】 山东大学 ， 病理学与病理生理学， 2005， 硕士

【摘要】 [目的]1. 检测Galectin-3、 Ki-67在甲状腺良、恶性肿瘤中的表达。2. 探讨Galectin-3、 Ki-67表达与甲状腺癌淋巴结转移及肿瘤复发的关系。3. 研究Galectin-3、 Ki-67联合检测在鉴别甲状腺良、恶性肿瘤中的应用价值。[方法]1. 采用免疫组织化学方法(SP法)检测甲状腺癌组织、癌旁组织中Galectin-3、 Ki-67蛋白的表达情况。以扁桃体组织作Ki-67阳性对照,以间变性大细胞淋巴瘤作Galectin-3阳性对照。2. 阳性判断标准:Galectin-3和Ki-67分别以肿瘤细胞质内及胞核内出现棕黄色颗粒为阳性判断标准。按阳性细胞所占百分比并参考着色强度确定分级如下:无明显阳性细胞为阴性;阳性细胞数<25%为弱阳性(+);阳性细胞25%-50%为中度阳性(++);阳性细胞>50%为强阳性(+++)。[结果]1. Galectin-3在甲状腺肿瘤中的表达:67例甲状腺癌中59例表达阳性,阳性率88. 06%,阳性细胞弥漫性分布,其中,甲状腺滤泡癌22例、乳头状癌24例、髓样癌10例、未分化癌3例阳性。癌旁组织中Galectin-3表达全部阴性。19例腺瘤仅3例呈弱阳性(15. 79%),阳性细胞呈小灶性分布。良、恶性病变之间比较,差异有高度显著性(P<0. 001) 。甲状腺癌各组织学类型之间比较,差异无显著性意义(P>0. 05) 。2. Ki-67在甲状腺肿瘤中的表达:甲状腺腺瘤中Ki-67阳性率为26. 32%,而甲状腺癌的阳性率为76. 12%,两组比较,差异有高度显著性(P<0. 001) 。甲状腺癌各组织学类型之间比较,差异无显著性意义(P>0. 05) 。3. Galectin-3和Ki-67与甲状腺癌转移的关系:43例有淋巴结转移的甲状腺癌中Galectin-3阳性者41例(95. 35%),Ki-67阳性者38例(88. 37%),与无淋巴结转移组相比较,差异有显著性意义(P<0. 01) 。4. Galectin-3和Ki-67与甲状腺癌复发的关系:37例复发病例中Galectin-3阳性率为97. 29%,与无复发组比较,差异有统计学意义(P<0. 05) ;Ki-67阳性率为89. 19%,与无复发组比较,差异有显著性意义(P<0. 025) 。[结论]山东大学硕士学位论文 Galeetin一3、Ki一67的表达与甲状腺癌的发生、发展、转移及预后有关,可以作为识别甲状腺癌的早期标记物以及评价甲状腺癌具有淋巴结转移及肿瘤复发潜能的指标。Galeetin一3和Ki一67的表达呈正相关,两者联合检测可有效地区别良、恶性甲状腺肿瘤,可作为监测肿瘤发生、发展及判断预后的指标。l关键词】甲状腺癌滤泡性肿瘤诊断Galectin一3Ki一67免疫组织化学预后更多还原

【Abstract】 Objective1. To detect the expression of Galectin-3 and Ki-67 in benign and malignant thyroid neoplasms.2. To investigate the relationship of Galectin-3 and Ki-67 expression, lymph node metastasis and prognosis of thyroid carcinomas.3. To study the value of Galectin-3 and Ki-67 detection in differentiating benign from malignant thyroid neoplasms.Methods1. Immunohistochemical staining: 67 samples of resected thyroid carcinoma tissues (cancer and adjacent-cancer) and 19 cases of adenomas were examined by streptavidin/peroxidase (S-P) immunohistochemical technique. Sections from human anaplastic large cell lymphoma were used as Galectin-3 positive control.2. Cellular localization: Galectin-3 staining reaction was seen in the cytoplasm, and. Ki-67 was nuclear staining. Immunostaining was evaluated as follows: - , none of neoplastic cells with positivity; +, <25% of neoplastic cells with positivity; ++, from 25% to 50% of neoplastic cells with positivity; +++, >50% of neoplastic cells with strong positivity.Results1. The expression of Galectin-3 in thyroid neoplasms: 59cases of thyroid carcinomas (22/24 follicular carcinomas, 24/27 papillary carcinomas, 10/12 medullary carcinoma and 3/4 anaplastic carcinomas) showed cytoplasmic immunohistochemical staining of Galectin-3, which was diffuse. As to the group of adenomas, only 3 cases were focally and weakly positive. None expression in the tissues of adjacent-cancer.There was significant difference between the expression of Galectin-3 in malignant thyroid tumors and that in benign lesions(P<0.001), and had no difference in four histological types(P>0.05).2. The expression of Ki-67 in thyroid neoplasms: only 5 cases of thyroid adenomas were positive, while 76.12% cases of thyroid carcinomas were positive. There was significant difference between the expression of Ki-67 in malignant thyroid tumors and that in benign lesions(P<0.001), and had no difference in four histological types(P>0.05).3. Among the 43 cases with lymph node metastasis, 41 cases expressed Galectin-3, and 38 cases expressed Ki-67, significantly different with non-lymph node metastasis(P<0.01).4. Among the 37 cases with tumor recurrence, the expression of Galectin-3 and Ki-67 were 97.29% and 89.19%, significantly different with non-recurrence(P<0.05, P<0.025).ConclusionThe results suggest that overexpression of Galectin-3 and Ki-67 play an important role in the thyroid carcinomas. The expression of Galectin-3 and Ki-67 in tumor tissues, is associated with tumor occurrence, progression, metastasis and recurrence in thyroid carcinomas. They may be effective in differentiating benign from malignant thyroid carcinoma, and can be regarded as valuable molecular markers for the tumor progression, recurrence and prognosis.更多还原