CD56、BRAF和CD15在甲状腺乳头状癌伴核病变鉴别诊断中的价值

IF 2.9 4区医学 Q2 PATHOLOGY

Pathology, research and practice Pub Date : 2025-05-20 DOI:10.1016/j.prp.2025.156030

Ricard Onieva Carbajo , Joan Carles Ferreres Piñas , Marta Alcalà Lorente , Ismael Capel Flores , Albert Cano Palomares , Berta Bella Burgos , Francisco Javier Guirao Garriga , Víctor Pérez-Riverola , Maria Rosa Escoda Giralt , Santiago Barcons Vilaplana , Roser Monmany Badia , Khalid El Hamshari Rebollo , Catalina Padilla Navas , Maria Rosa Bella Cueto

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引用次数: 0

摘要

具有乳头状癌样核特征的甲状腺病变的鉴别诊断包括低风险实体，如具有乳头状样核特征的滤泡性甲状腺瘤（NIFTP）和高风险实体，如乳头状甲状腺癌（TCS）的高细胞亚型。形态学标准是区分它们的必要条件，但使用免疫组织化学技术来区分这些实体是可取的。材料与方法选择TCS 8例，经典亚型（CS） 27例，NIFTP 20例。对每个病例进行BRAF、CD56、B-Catenin、CD15、Muc-1和Napsin A的免疫组化染色，并与组织学诊断相关联。结果所有TCS患者BRAF和CD15阳性（p <； 0.05，与CS比较），CD56无阳性。在乳头状癌（TCS和CS）和NIFTP的比较中，BRAF、CD56和CD15的免疫染色差异有统计学意义。结论BRAF、CD56和CD15免疫染色可用于区分NIFTP、CS和TCS，可以鉴别出CD56阴性、BRAF阳性和CD15阳性（TCS占100% %，CS占35% %）和CD56阳性、BRAF阴性和CD15阴性（NIFTP占52% %，CS占7% %）的肿瘤，有助于诊断。

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Usefulness of CD56, BRAF and CD15 in the differential diagnosis of thyroid lesions with nuclear features of papillary carcinoma

Introduction

Differential diagnosis of thyroid lesions with papillary carcinoma-like nuclear features includes low-risk entities, such as follicular thyroid neoplasia with papillary-like nuclear features (NIFTP), and high-risk entities, such as the tall cell subtype of papillary thyroid carcinoma (TCS). Morphological criteria are essential to distinguish them, but having immunohistochemical techniques to discriminate between these entities would be desirable.

Materials and methods

8 TCS, 27 papillary carcinomas of classic subtype (CS) and 20 NIFTP were selected. Immunohistochemical staining for BRAF, CD56, B-Catenin, CD15, Muc-1 and Napsin A was performed for each case and correlated with the histological diagnosis.

Results

All TCS cases were positive for BRAF and CD15 (p < 0.05 compared to CS) and none showed positivity for CD56. In the comparison of papillary carcinoma (TCS and CS) and NIFTP, immunostaining for BRAF, CD56 and CD15 showed statistically significant differences.

Conclusions

BRAF, CD56 and CD15 immunostaining are useful to differentiate between NIFTP, CS and TCS, making it possible to identify a group of tumours with the combination CD56 negative, BRAF positive and CD15 positive that includes 100 % of TCS and 35 % of CS and a group of CD56 positive, BRAF negative and CD15 negative tumours that includes 52 % of NIFTP and 7 % of CS, facilitating the diagnosis.

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来源期刊

Pathology, research and practice 医学-病理学

CiteScore

5.00

自引率

3.60%

发文量

405

审稿时长

24 days

期刊介绍： Pathology, Research and Practice provides accessible coverage of the most recent developments across the entire field of pathology: Reviews focus on recent progress in pathology, while Comments look at interesting current problems and at hypotheses for future developments in pathology. Original Papers present novel findings on all aspects of general, anatomic and molecular pathology. Rapid Communications inform readers on preliminary findings that may be relevant for further studies and need to be communicated quickly. Teaching Cases look at new aspects or special diagnostic problems of diseases and at case reports relevant for the pathologist''s practice.