갑상선 결절에서 Galectin-3 및 Thyroid Peroxidase의 발현 = Galectin-3 and Thyroid Peroxidase Expression in Thyroid Nodules

다국어 초록 (Multilingual Abstract)

Background: The accurate diagnosis of a thyroid nodule is important in deciding a patient's treatment plan and for predicting the prognosis. The histopathological diagnosis of resected specimens are largely positively accomplished, but the consistency of the diagnosis is low when the specimen shows a small carcinomatous cytological feature or the nodule does not express papillary proliferation. Therefore, the need for supplementary diagnostic measures is increased. Herein, the expressions of galectin-3 and thyroid peroxidase (TPO) of resected specimens were investigated using immunohistochemical staining, and their potential for contributing to an accurate diagnosis studied. Methods: The specimens included 195 resected thyroid nodules obtained from 179 patients having undergone thyroid surgery. Immunohistochemical staining for two useful antibodies, galectin-3 and TPO, were performed, and the expressions of these two antibodies investigated with regard to the histological diagnosis. Results: The sensitivity, specificity, and positive and negative predictive values of galectin-3 and TPO for detecting papillary carcinomas were all 100%, but these values were low for other forms of carcinoma. Conclusion: Our data showed the diagnosis of thyroid nodules, using immunohistochemical staining for galectin-3 and TPO, was very useful for detecting thyroid papillary carcinoma, but insufficiently sensitive for follicular carcinoma. Immunohistochemical staining for TPO is also useful for distinguishing cases when a false positive result for galectin-3 is obtained. (J Kor Endocrine Soc 22:105~111, 2007)

국문 초록 (Abstract)

배경: 갑상선 결절의 정확한 진단은 치료와 예후의 결정에 매우 중요하다. 절제 표본에 대한 병리학적 진단은 대부분 명확하게 이루어지나 특수한 경우 병리학자들 간의 진단 일치율이 매우 낮다. 더욱이 세포도말 표본에서는 세포의 수는 제한적이므로 진단에 어려움이 있어 진단에 보조적인 방법의 개발이 필요하다. 저자들은 절제된 조직에서 galectin-3와 TPO에 대한 면역조직화학 염색을 시행하여 갑상선의 다양한 결절성 병변에서 발현 양상을 조사하여 결절의 정확한 진단에 기여할 수 있는지를 검토하였다방법: 179명의 환자로부터 절제한 195개의 갑상선 결절성 병변을 대상으로 galectin-3와 TPO에 대한 면역조직화학염색을 시행하여 조직학적 진단에 따른 두 항원의 발현을 조사하였다. 결과: 갑상선 유두암에서 galectin-3와 TPO의 민감도, 특이도, 양성 예측도, 음성 예측도는 모두 100%로 나타났으나 다른 암종들에 대해서는 비교적 낮게 나타났다.

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