甲状腺原发性乳头状癌合并鳞状细胞癌临床病理分析-东南大学学报医学版

甲状腺原发性乳头状癌合并鳞状细胞癌临床病理分析

单位：南京大学医学院附属鼓楼医院,病理科,江苏,南京,210008

分类号：R736.1

出版年·卷·期（页码）：2007·26·第三期（213-216）

摘要：

目的:探讨甲状腺原发性乳头状癌(PC)合并鳞状细胞癌(SCC)的病理形态特点、组织发生、病因、诊断、鉴别诊断、治疗及预后.方法:标本采用常规石蜡切片,行HE染色和EnVision免疫组化二步法染色,并应用EBER-1-Dig探针原位杂交检测EB病毒.结果:光镜下见甲状腺肿块内同时存在乳头状癌和鳞状细胞癌两种成分.免疫组化染色示乳头状癌表达AE3( + ),AE1( + + ),TTF-1( + + + ),TG( + + + ),CK19( + + + ),Ki-67( + ),p53( - );鳞状细胞癌表达AE3( + + + ),AE1( + ),TTF-1( + ),TG( - ),CK19( + + + ),Ki-67( + + + ),p53( - ).原位杂交见乳头状癌及鳞状细胞癌表达EB病毒( + ),均定位于癌细胞核.结论:甲状腺内存在乳头状癌和鳞状细胞癌两种成分,鳞状细胞癌可能由胚胎发育期残留于甲状腺的鳞状上皮或甲状腺滤泡上皮鳞状化生恶变而来.EB病毒感染可能与癌的发生有关.

Objective To explore the pathology morphological features,histogenesis,etiology,diagnosis,differential diagnosis,therapy and prognosis of the primary thyroid papillary carcinoma(PC) complicated with squamous cell carcinoma(SCC).Methods Two cases of PC complicated with SCC were studied by paraffin slice,HE staining,immunohischemistrical method(EnVision method) and hybridization in situ(EBER-1Dig).Results Under microscope,the tumors showed typical components of the PC and the SCC.Immunohistochemistry stain revealed that the PCs were reactive to antibodies of AE3(+),AE1(++),TTF-1(+++),TG(+++),CK19(+++),Ki-67(+) and p53(-),whereas the SCCs to AE3(+++),AE1(+),TTF-1(+),TG(-),CK19(+++),Ki67(+++),p53(-).Hybridization in situ showed that the EB virus mRNA located in the nuclei but not in the cytoplasm of the PC and SCC.Conclusions The components of PC and SCC are found in the samples.The SCC might originate from the squamous epithelium remained in the thyroid during the embryonic development or derived from the squamous metaplasia of the thyroid follicular epithelium.The EB viral infection is related with the oncogenesis of both of the thyroid follicular epithelium and squmous epithelium in the thyroid.

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