Expression of Ki-67, galectin-3, fragile histidine triad, and parafibromin in malignant and benign parathyroid tumors
Expression of Ki-67, galectin-3, fragile histidine triad, and parafibromin in malignant and benign parathyroid tumors
复制标题
DOI：
10.3760/cma.j.issn.0366-6999.2012.16.018
复制
发表时间：
2012-08-20
影响因子：
6.1
通讯作者：
Xing Xiao-ping
中科院分区：
文献类型：
--
作者：
Wang Ou;Wang Chun-yan;Xing Xiao-ping
人们普遍认为，甲状旁腺癌（PC）的诊断往往是困难的，因为恶性和良性甲状旁腺肿瘤的特征重叠，特别是在早期。本研究旨在探讨Ki-67、半凝集素-3、脆性组氨酸三联体（FHIT）基因和副纤维蛋白在PC、甲状旁腺腺瘤（PA）、甲状旁腺增生（PH）和正常甲状旁腺（NP）组织中的表达差异；然后评估这些表达值在恶性和良性甲状旁腺肿瘤鉴别诊断中的应用。方法回顾性分析15例PC、19例PAs、8例PHs的临床资料。免疫组化法检测Ki-67、半乳糖凝集素-3、FHIT、parafibromin在上述标本和6个NPs中的表达。结果15例甲状旁腺癌中有9例（60%）的旁腺蛋白表达完全缺失，除1例（4%）腺瘤外，其余正常甲状旁腺组织和良性甲状旁腺癌的旁腺蛋白均呈阳性。15例癌组织中有11例（73%）、19例腺瘤组织中有5例（26%）、8例增生组织中有1例（12%）、6例正常组织中无半乳糖凝集素-3染色阳性。15例癌中有4例（27%）Ki-67增殖指数高，19例腺瘤中有1例（5%）Ki-67增殖指数高，无增生或正常组织。FHIT的表达在不同肿瘤类型间无明显差异。半乳糖凝集素-3过表达或parafibromin缺失的组合可使PC的敏感性提高至87%，而半乳糖凝集素-3阳性和Ki-67阳性的特异性均可达到100%。结论：这些数据提示，半凝血素-3和Ki-67的过表达可能有助于区分甲状旁腺癌和其他甲状旁腺肿瘤。其中两种或三种标志物的结合可能对甲状旁腺癌的诊断产生更好的敏感性和/或特异性。中华医学杂志2012；125 (16): 2895 - 2901
Background It is widely recognized that the diagnosis of parathyroid carcinoma (PC) is often difficult because of the overlap of characteristics between malignant and benign parathyroid tumors, especially at an early stage. Our study aimed to investigate the differential expression of Ki-67, galectin-3, fragile histidine triad (FHIT) gene, and parafibromin in PC, parathyroid adenoma (PA), parathyroid hyperplasia (PH), and normal parathyroid (NP) tissues; then to assess these expression values for use in differential diagnosis of malignant and benign parathyroid tumors.Methods Data of 15 cases with PC, 19 PAs, and 8 PHs were retrospectively analyzed for their clinical characteristics. The expression of Ki-67, galectin-3, FHIT, and parafibromin were detected via immunohistochemistry in the above-mentioned specimens and 6 NPs as control.Results Complete loss of parafibromin expression was seen in 9 of 15 (60%) carcinomas, and all normal parathyroid tissues and parathyroid benign tumors stained positive for parafibromin except for one (4%) adenoma. Galectin-3 staining was positive in 11 of 15 (73%) carcinomas, 5 of 19 (26%) adenomas, 1 of 8 (12%) hyperplasias, and 0 of 6 normal tissues. The Ki-67 proliferative index was high in 4 of 15 (27%) carcinomas, 1 of 19 (5%) adenomas, and none of the hyperplasia or normal tissues. FHIT expression did not differ appreciably among the tumor types. The combination of overexpression of galectin-3 or loss of parafibromin increased sensitivity for PC to 87%, while the specificity of both positive galectin-3 and positive Ki-67 could reach 100%.Conclusions These data suggested that loss of parafibromin and overexpression of galectin-3 and Ki-67 might help to distinguish parathyroid carcinoma from other parathyroid tumors. And the combination of two or three of these markers might produce better sensitivity and/or specificity for the diagnosis of parathyroid carcinoma. Chin Med J 2012;125(16):2895-2901