内科

目的探讨桥本甲状腺炎(HT)合并乳头状甲状腺癌(PTC)患者RAS蛋白、半乳糖凝集素-3(Gal-3)、细胞角蛋白19(CK-19)的表达水平及临床意义。方法选取我院病理科提供的2015年7月至2016年7月所收集的患者HT标本27份，PTC标本26份，HT合并PTC标本26份作为研究对象，同期选取24份正常甲状腺组织标本为对照组，采用免疫组织化学(S-P)方法检测标本组织中RAS、Gal-3、CK-19表达水平。结果HT合并PTC组织存在滤泡上皮细胞过度增生并向非典型增生细胞团过渡，以及非典型增生细胞团向乳头状癌移行过渡的现象；HT组织中RAS、Gal-3、CK-19阳性表达率明显高于正常甲状腺组织(P＜0.05)，PTC组织中RAS、Gal-3、CK-19阳性表达率明显高于HT组织(P＜0.05)，HT合并PTC组织中RAS、Gal-3、CK-19阳性表达率明显高于PTC组织(P＜0.05)。HT合并PTC组织中正常滤泡上皮细胞中RAS、Gal-3、CK-19蛋白表达均呈阴性，非典型增生滤泡上皮细胞中RAS、Gal-3、CK-19蛋白呈现不同程度阳性表达，乳头状癌组织中RAS、Gal-3、CK-19蛋白均呈强阳性表达，不同组织的RAS、Gal-3、CK-19蛋白阳性表达率比较差异具有统计学意义（P＜0.01）。结论HT具有恶变为PTC的潜能，RAS、Gal-3、CK-19参与HT合并PTC的发生及发展，可作为HT向PTC癌变发展的早期预测指标。

ObjectiveTo investigate the expression of RAS, Gal-3, CK-19 and its clinical significance in patients with hashimoto′s thyroiditis complicated with papillary thyroid carcinoma. MethodsA total of 27 cases of HT tissues, 26 cases of PTC tissues and 26 cases of HT complicated with PTC tissues were selected from pathology department in our hospital from July 2015 to July 2016, and 24 cases of normal thyroid tissue were selected as the control group. The levels of RAS, Gal-3 and CK-19 in the tissues were detected by S-P method. ResultsHT combined with PTC had the phenomenon of transition from excessive proliferation of follicular epithelial cells to atypical hyperplasia and atypical hyperplasia of cell clusters to papillary carcinoma; the positive expression rates of RAS, Gal-3 and CK-19 in the HT tissues were significantly higher than those in the normal thyroid tissue(P＜0.05), the positive expression rates of RAS, Gal-3 and CK-19 in the PTC tissues were significantly higher than those in the HT tissue(P＜0.05), and the positive expression rates of RAS, Gal-3 and CK-19 in HT complicated with PTC tissues were significantly higher than those in the PTC tissue(P＜0.05). The expression of RAS, Gal-3 and CK-19 protein in normal follicular epithelial cells of HT and PTC tissue were negative, the expression of RAS, Gal-3 and CK-19 protein in atypical hyperplastic follicular epithelial cells showed different degrees of positive expression, the expression of RAS, Gal-3 and CK-19 in papillary carcinoma was strongly positive,there was significant difference in the expression of RAS, Gal-3 and CK-19 among three tissue(P＜0.01). ConclusionsHT has malignant potential to PTC, and RAS, Gal-3, CK-19 involved in the occurrence and development of HT complicated with PTC and can be an early predictive index of development of HT complicated with PTC .