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甲狀腺腫瘍에서 Cytokeratin과 Carcinoembryonic Antigen의 免疫組織化學的 硏究
洪在三,金世民 고려대학교 의과대학 1990 고려대 의대 잡지 Vol.27 No.1
Several tumor markers have been identified in various malignant tumors since Gold had introduced carcinoembryonic antigen in 1965. A few thyroid tumor markers have been introduced and investigated since Bussolati introduced calcitonin as a tumor marker of thyroid medullary carcinoma in 1973. Those subjected to be discussed as thyroid tumor markers in recent years are calcitonin, thyroglobulin, epithelial membrane antigen, carcinoembryonic antigen and cytokeratin. The detection of these tumor markers distribution in the tissues has been facilitated by introducing immunoperoxidase staining and a few articles dealing with cytokeratin and carcinoembryonic antigen in thyroid tumors have been published in recent years. For the purpose of evaluating the diagnostic values of cytokeratin and carcinoembryonic antigen in thyroid tumors, retrospective study was carried out using immunoperoxidase methods. The presence of cytokeratin and carcinoembryonic antigen was evaluated in different types of thyroid neoplasms including 5 diffuse hyperplasia, 5 adenomatous hyperplasia, 10 follicular adenoma, 16 papillary carcinoma, 12 follicular carcinoma and 2 cases of anaplastic carcinoma. Immunoperoxidase study was performed using monoclonal antibodies to cytokeratin proteins and carcinoembryonic antigens. Cytokeratin expression was found in benign( 18/20, 90% ) and malignant tumors( 28/ 30, 93.3% ), but carcinoembryonic antigen was predominantly found in maligant tumors (23/30, 76.7%) compared with benign tumors(8/20, 40% ). Both cytokeratin and CEA was found in all cases of papillary carcinoma(l6/16, 100%), but follicular carcinoma showed more positive staining reaction with anti -cytokeratin antibody(l0/12, 83.3%) than anti-CEA antibody(5/12, 41.7%). The degree of expression of cytokeratin and carcinoembryonic antigen was stronger in malignant tumor than benign tumor, and stronger in papillary carcinoma than follicular carcinoma. Hence, the analysis of cytokeratin and carcinoernbryonic antigen can be utilized to differentiate between papillary carcinoma and follicular carcinoma as well as between benign and malignant tumor.