Peroxidase-PAM-Double-Staining-Method (PPDS法) 導入による各種甲状腺疾患の形態的機能解析

Abstract

The author noted that the endogenous peroxidase (TPO) is related closely with the hormone biosynthesis and the thyroglobulin (T) is mainly constituted of the glycoprotein. The TPO is most sensitively demonstrated by Karnovsky method and the T is most likely demonstrable with the Periodic Acid Methenamine Silver (PAM) stain procedure. In this connection, the author developed efficient and accurate method (peroxidase-PAM-double-staining-method) (PPDS) which is able to demonstrate the both constitutions simultaneously. In this report, the author has made a correlative study from functional and morphological aspects of the various thyroid diseases. Moreover, a semi-quantitative investigation of the TPO has been performed.The following thyroid diseases have been investigated. Hyperthyroidism: 40 cases, adenoma: 20 cases, adenomatous goiters: 11 cases, carcinoma: 10 cases, Hashimoto's thyroiditis: 5 cases, then summing up to 86 cases. The PPDS reaction was performed on the identical sections both in light and electron microscopy. The electron microscopic semi-quantitative study was attempted to visualize the TPO positive deposits in a single cell. The light microscopic TPO positive deposits and T reactive patterns and thier localization were scored.The results were as follows:(i) The PPDS score point system indicates the full points (10 points) in normal autopsied thyroid gland. Hyperthyroidism, 9.8±6.25 (papillary) type: 11.0±4.26, non-papillary type: 8.0±2.77), adenoma (colloid adenoma: 9.2±3.41, follicular adenoma: 14.0±3.95, functioning adenoma: 18.0±2.09, non-funct. adenoma, 8.0±1.71). Adenomatous goiter, 6.5±2.11 (carcinoma) (papillary type), 5.4±1.07, follicular type: 8.3±2.45), Hashimoto's thyroiditis: 4.2±1.28.(ii) Based on the observation of the semi-quantitative study of the electron microscopically demonstrable TPO, the normal thyroid: 13.4±6.08, adenoma (functioning type: 43.9±5.05, non-functioning type: 13.1±6.78), hyperthyroidism: 22.9±11.0, adenomatous goiter: 6.9±2.81, carcinoma: 1.64±1.62.(iii) In accordance with 131I-uptake rate, the TPO was increased on quantitative basis.(iv) The localization of the TPO was in a full agreement with the observation of the other authors. The mitochondrial cristae also showed the positive reaction to the TPO procedure.(v) The vesicles which were transmitted through the Golgiassociated ER disclosed similar reaction to it.Conclusively, the author revealed significant increase of the TPO in functioning adenoma and papillary variety of the hyperthyroidism which is demonstrated in virtue of the PAM technique. The observation may indicate a possibility that the localization and quantitative increase of the PPDS reaction may reflect activated hormonal biosynthesis.