甲状腺乳头状癌伴神经内分泌分化的免疫组化、超微结构及免疫金标记研究
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南通市社会发展科技计划(S5010)


Immunohistochemical,ultrastructural analysis and immunogold labelling of papillary thyroid carcinoma with neuroendocrine differentiation
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    摘要:

    目的:探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的神经内分泌(NE)分化与临床病理形态学特征及预后因素的关系。方法:手术切除PTC 103例,行HE染色后光镜下观察-免疫组织化学染色后光镜及透射电镜检查-免疫金标记后电镜观察PTC临床病理形态学-光镜及电镜下NE标记(NSE-CgA-Syn)表达及电镜CgA 标记的致密核心颗粒表达;分析上述NE标记表达与临床病理参数及预后因素的关系。结果:PTC表达NSE 64例(62.14%),与肿瘤直径呈正相关(P < 0.05);表达CgA25例(24.27%),与肿瘤分化程度呈负相关,与核内包涵体呈正相关(P < 0.05);Syn 均呈阴性;NSE及CgA共同表达23例(22.33%)。透射电镜PTC致密颗粒检出率为18.2%(12/66);PTC细胞分化程度-肿瘤直径与NE分化有关(P < 0.05);免疫金标记电镜观察CgA免疫金颗粒3例(2.91%)。CgA定位于PTC癌细胞胞浆内的NE颗粒边缘呈散在分布。结论:PTC中NE分化细胞可能来源于滤泡上皮细胞;NE分化与PTC瘤体直径-细胞核形态改变及癌细胞分化程度有关,与预后无关。

    Abstract:

    Objective:To investigate the correlation between neuroendocrine(NE)differentiation and clinico-pathological features,prognostic factors of papillary thyroid carcinoma(PTC). Methods:The tissues of 103 PTC cases were amaylzed by HE staining,immunohisto-chemistry,immunogold labelling,biomarkers expression of neuroendocrine differentiation. Results:Thyroglobulin was positively expressed in PTC,while Calcitonin was negative. The larger tumor size of the cases with PTC accompanied with a higher NSE expression(P < 0.05). The higher degree of differentiation accompanied with a lower rate of CgA expression. The cases with nuclear inclusions showed obviously increased expression of CgA(P < 0.05). The degree of PTC cell differentiation and tumor size were associated with NE differentiation under TEM(P < 0.05). The CgA immunogold particles were scattered at the internal edge of NE particles within the cytoplasm of PTC cells. Conclusion:NE differentiation could occur in PTC,and NE differentiated cells could be derived from follicular epithelial cells instead of C cells. NE differentiation is correlated with tumor size,morphological change of nuclei and degree of differentiation in PTC. NE differentiation has no significant correlation with the prognosis of PTC.

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张 婷,何 松,陈旭东,陆晓云,杨书云,周建云,张建兵,潘红佳,严 桥.甲状腺乳头状癌伴神经内分泌分化的免疫组化、超微结构及免疫金标记研究[J].南京医科大学学报(自然科学版),2013,(11):1529-1536

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  • 收稿日期:2013-04-30
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  • 在线发布日期: 2013-11-25
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