Application of immunohistochemical markers in the differential diagnosis of thyroid tumors

Abstract

Aim.To evaluate the expression of Galectin-3, Fibronectin-1, Cytokeratin-19 and HBME 1 in benign and malignant thyroid nodules and to assess their diagnostic value.Methods. Immunohistochemical analysis was performed on 59 surgically removed thyroid nodules, including 34 carcinomas (12 papillary, 2 tall cell variants, 3 lymph node metastases from papillary carcinoma, 5 follicular variants of papillary carcinoma (FVPTC), 3 anaplastic, 5 follicular and 4 Hürthle cell carcinomas), as well as 25 benign lesions (10 follicular adenomas, 4 Hürthle cell adenomas, 11 nodular goiters with surrounding normal thyroid tissue).Results. We found strong and diffuse Galectin-3 expression in all malignant lesions except for one case of FVPTC and one follicular carcinoma. Normal thyrocytes and the majority of the benign lesions were negative for all markers. Statistical analysis of each protein confirmed that Galectin-3 was the most sensitive (94%), followed by Cytokeratin-19 (88%). Fibronectin-1 and HBME 1 proved to be less sensitive (56% and 68%, respectively), but more specific (92% specificity for each of them). Coexpression of two or more proteins was restricted to carcinomas, while their concurrent absence was highly specific for benign lesions. Comparing the immunopositivity in follicular carcinoma versus adenoma we achieved 80% sen-sitivity for Galectin-3 and 100% specificity for HBME 1 . For distinguishing the Hürthle cell lesions, Fibronectin-1 turned out to be more sensitive than Galectin-3 and Cytokeratin-19.Conclusion. Our findings suggest that immunohistochemical panel consisting of Galectin-3, Cytokeratin-19, HBME 1 and Fibronectin-1 might contribute to differential diagnosis between malignant and benign thyroid nodules, including those with follicular architecture.

Skull Metastasis as the Presenting Feature of Mixed Medullary and Follicular Thyroid Carcinoma

“…However the lack of immunostaining for other markers for the assessment of the tumoral profile is a limitation of this report. Immunohistochemistry is beneficial not only in differentiating benign from malignant thyroid lesions, but it also helps in better characterization of mixed thyroid tumors (15). Although our patient had significant improvement in clinical symptoms following I 131 therapy, long-term prognosis in her is guarded.…”

Expression of CK-19 Immunomarker in Thyroid Neoplasm and its Association with Histopathology

“…This result was similar to other studies. 10,11 Hanan Alsaeid Alshenawy, stated in his study that CK-19 is always positive in papillary carcinoma in contrast to other thyroid malignancies. He reported that all 14 cases of papillary carcinoma showed positivity with cytokeratin 19 comprising 100%.…”

Role of Immunohistochemistry in Diagnosis of Papillary Thyroid Carcinoma: The Use of Ck19, CD56, P63 and CD117

“…The current study pointed that; the expression of CK19 in PTC including FVPTC was significantly higher than in other thyroid lesions including follicular neoplasms and hyperplastic nodules. Palo and Biligi and Siderova et al reported similar relation supporting that it can serve to differentiate PTC from follicular neoplasm [19,21]. However, other studies found higher expression of Ck19 in follicular neoplasm and hyperplastic nodules [18,20].…”

“…In our study, we selected only those papillary thyroid carcinomas In our study, CK19 strongly immunoreacted with (87.5%) cases of PTC; while negative cases (3 cases) show focal immunoreactivity in less than 10% hence considered negative. As shown in Table 4 previous studies reported CK19 expression in most of their studied PTC cases, ranging from 75.9% to 100% [16][17][18][19][20][21].…”