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局灶性淋巴细胞性甲状腺炎手术治疗及其滤泡细胞凋亡与增殖状况的免疫组化分析 |
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冯野 赵吉生 张德恒 崔俊生 周春健 孙辉 陈瑞新
【摘 要】 目的 探讨局灶性甲状腺炎和甲状腺癌的关系及手术治疗的可行性与必要性。方法 应用免疫组织化学方法对30例局灶性甲状腺炎，20例甲状腺乳头状癌，20例结节性甲状腺肿，5例正常甲状腺组织分别进行Bax,Ki-67染色，并对甲状腺炎病人进行12～40个月随访。结果 局灶性甲状腺炎标本Bax阳性分级明显高于其它各组；Ki-67阳性细胞数低于甲状腺癌，明显高于结节性甲状腺肿和正常甲状腺标本；随访30例甲状腺炎病人甲状腺功能正常。结论 局灶性甲状腺炎细胞增殖加速，应进一步探讨其癌变倾向，手术切除效果良好。
【关键词】 淋巴细胞性甲状腺炎 增殖 凋亡 甲状腺癌 手术
Operative treatment and immunohistochemical analysis of thyrocyte apoptosis and proliferation in focal lymphocytic thyroiditis
Feng Ye Zhao Jisheng Zhang Deheng
（The Third Clinical College,Norman Bethune University of Medical Sciences,Changchun 130031）
【Abstract】 Objective To investigate the relationship between focal lymphocytic thyroiditis and thyroid papillary carcinoma and feasibility and necessity of operation for local lymphocytic thyroiditis.Methods 30 cases of focal lymphocytic thyroiditis,20 cases of thyroid papillary carcinoma,20 cases of nodular goiter and 5 cases of normal thyroid were stained with monoclonal antibodies directed against Bax,Ki-67.The patients with lymphocytic thyroiditis had been followed up for 12～40 months.Results Bax positive cell rate of focal lymphocytic thyroiditis was significantly higher than other groups.Ki-67 positive cells in focal lymphocytic thyroiditis were less than thyroid papillary carcinoma,but significantly more than nodular goiter and normal thyroid.Thyroid function of all 30 patients with thyroiditis was normal during follow-up.Conclusion Proliferation of thyrocyte accelarates in focal lymphocytic thyroiditis,and we should study the possibility of developing into thyroid carcinoma.Operation is a good treatment.
【Key words】 Lymphocytic thyroiditis Proliferation Apoptosis Thyriod carcinoma Operation
淋巴细胞性甲状腺炎(lymphocytic thyoiditis,LT)是以淋巴细胞浸润为主要病理特征的免疫性疾病，近年来我们在临床工作中发现其发病率有增高趋势，尤其以局灶性甲状腺炎的发病率增高更为明显［1］。其中有些病人与甲状腺癌不易鉴别，为了探讨局灶性甲状腺炎和甲状腺癌(thyriod carcinoma)的关系以及手术治疗的可行性和必要性，我们对近年来在我院外科接受手术治疗的30例局灶性甲状腺炎病人进行了随访，并对其标本通过Bax\,[1] [2] 下一页
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