摘要目的 探讨Twist基因蛋白在甲状腺乳头状癌中的表达状况,寻找更特异的标记物,用于甲状腺乳头状癌(PTC)与滤泡状腺瘤(FA)和良性乳头病变(BPL)的鉴别诊断.方法 以50例PTC为研究组,以48例FA和47例BPL作对照组.在自制组织芯片上行免疫组织化学(SP法)标记,检测Twist基因蛋白和HBME-1,并以CK19进行对照.结果 3种指标(Twist、HBME-1、CK19)阳性表达率:在PTC组分别为100%(48/48)、94.0%(47/50)和78.0%(39/50);在FA组分别为0、6.7%(3/45)和0;在BPL组分别为7.0%(3/43)、2.1%(1/47)和0.PTC组分别与FA和BPL组比较差异均有统计学意义(P=0.000).3种指标在鉴别诊断甲状腺良、恶性病变的灵敏度分别为:100%、96.4%和97.7%,特异度分别为:94.0%、95.7%和95.1%,准确度分别为:78.0%、100%和91.9%.结论 Twist可应用于辅助诊断PTC,并可应用在对FA或BPL的鉴别诊断.

abstractsObjective To study Twist expression in thyroid papillary carcinoma(PTC)by immunohistochemistry and to assess its usefulness as marker in the differential diagnosis of PTC.follicular adenomas(FA)and benign papillary lesions(BPL).Methods Fifry cases of PTC,48 cases of FA and 47cases of BPL were evaluated using manual tissue chip and SP immunohistochemical stain to detect the expression of Twist and HBME-1,and comparing the staining to that of cytokeratin19(CK19).Resuits In PTC.positive rates of Twist,HBME-1 and CK19 were 100%(48/48),94.0%(47/50)and 78.0%(39/50)respectively;in FA,positive rates were 0,6.7%(3/45)and 0 respectively;in BPL,positive rates were 7.0%(3/34),2.1%(1/47)and 0,respectively.The differences between PTC and FA and between PTC and BPL were both statistically significant(P=0.000).The sensitivity of Twis,HBME-1 and CK19was 100%,94.0%and 78.0%;the specifity was 96.4%,95.7%and 100%;overall accurary was97.7%.95.1%and 91.9%.respectively.Conclusions Positive rates of Twist is higher than the other markers in PTC.Immunohistochemical staining of Twist has important significance in the difierential diagnosis of thyroid lesions.Twist immunohistochemistry may be helpful in diagnosis and differential diagnosis of PTC.