Development of new indicator in biological malignancy of thyroid carcinoma preoperatively using aspiration biopsy cytology (ABC)

为了在术前确定甲状腺癌的生物学恶性程度，我们首先尝试对抽吸活检的细胞学标本进行免疫染色。然而，由于技术困难，这一努力失败了。因此，我们决定尝试通过组织标本的免疫组织化学检查来确定甲状腺癌的恶性程度。C-myc p62、C-Ha-ras p21、表皮生长因子(EGF)、转化生长因子(TGFpha)和雌激素受体(ER)的表达可作为肿瘤恶性程度的指标。1.C-myc p62在预后不良的未分化癌中高表达(91.7%)。有乳头状癌淋巴结转移的患者中免疫活性阳性的比例特别高(P&lt；0.01)。在ER阳性细胞数目较多的癌中，EOPTC(一种预后指标)的值较低，且ER阳性率与预后呈负相关。C-Ha-ras p21、EGF、TGFα阳性表达与甲状腺癌的组织学类型及临床恶性程度无明显相关性。通过检查这些不同指标的表达，不可能鉴别诊断滤泡性腺瘤和滤泡性癌。技术上的困难。因此，我们决定尝试通过检查滤泡癌是不可能的根据这些发现，可以说，C-myc p62和ER的表达是有价值的指标甲状腺癌的恶性程度。还应该注意的是，完美的术前鉴别诊断髓样癌和未分化癌是可能的，通过比较癌胚抗原的表达和手术前抽吸细胞学标本中的降钙素的表达，即成功地实现了我们最初的目的。

With the aim of preoperative determination of the biological malignancy of thyroid carcinoma, we first attempted immunological staining of cytologic specimens collected by aspiration biopsy. However this failed due to technical difficulties. Thus, we decided to attempt to determine the malignancy of thyroid carinoma by immunohistochemical examination of histologic specimens. Expression of C-myc p62, C-Ha-ras p21, epidermal growth factor (EGF), transforming growth factor (TGFalpha), and estrogen reception (ER), as indicators of malignancy, was observed/ The findings are summarized as follows:1. Immunological activity of C-myc p62 was expressed at a high frequency (91.7%) in undifferentiated carinomas having a poor prognosis. A particularly high ratio of patients with papillary carcinoma lymphnode metastasis were positive for the immunological activity (P<0.01).2. In carcinomas involving a larger number of Erpositive cells, lower values of EOPTC (an index of prognosis) were obtained, with a negative correlation of the ERpositivity ratio with prognosis.3. There was no definite correlation of the ratio of patients positive for c-Ha-ras p21, EGF or TGFalpha, with the histologic type or clinical malignacy of thyroid carinoma.4. Differential diagnosis of follicular adenoma and follicular carcinoma was impossible by an examination of the expression of these various indicators. to technical difficulties. Thus, we decided to attempt follicular carcinoma was impossible by an examination of Bases on these findings, it can be said that C-myc p62 abd ER in their expression are valuable as indicators of malignancy of thyroid carcinoma.It should also be noted that perfect preoperative differential diagnosis of medullary carcinoma and undifferentiated carcinoma was possible by comparing the expression of carcinoembrionic antigen and that of carcitonin on cytologic specimens collected by aspiration before surgery, i.e., our initial aim was successfully accomplished.