Defining the value of CD56, CK19, Galectin 3 and HBME-1 in diagnosis of follicular cell derived lesions of thyroid with systematic review of literature

Abstract

BackgroundNodular follicular lesions of thyroid gland comprise benign and malignant neoplasms, as well as some forms of hyperplasia. “Follicular” refers to origin of cells and in the same time to growth pattern - building follicles. Nodular follicular thyroid lesions have in common many morphological features, therefore attempts were made to define additional criteria for distinction between follicular adenoma, follicular carcinoma and follicular variant of papillary carcinoma. Increasing number of immunohistochemical markers is in the continual process of evaluation.MethodsTissue microarrays incorporating, total 201 cases, out of which 122 malignant and 79 benign follicular lesions, including neoplastic and non-neoplastic, were constructed and immunostained with antibodies to CD56, CK19, Galectin-3, HBME-1. Tissue cores were exclusively being acquired from tumour/lesion on interface with normal thyroid tissue. A systematic review of literature was done for period from the year 2001 to present time.ResultsAll analysed markers may make a difference between benign lesions/tumours from differentiated thyroid carcinomas (p = <0.01, for all markers). Expression of all markers is significantly higher in papillary carcinoma than in follicular adenoma (p < 0.01). Statistically significant difference in expression of Galectin-3 and CD56 between follicular carcinoma and follicular adenoma was registered (p = 0.043; p = 0.028, respectively). The only marker which expression showed statistically significant difference between adenoma and carcinoma of Hurthle cells was Galectin 3 (p = 0.041). CK19 and HBME-1 were significantly expressed more in papillary carcinoma as compared to follicular carcinoma.ConclusionGalectin 3 is most sensitive marker for malignancy, while loss of expression of CD56 is very specific for malignancy. Expected co-expression for combination of markers in diagnosis of follicular lesions decreases sensitivity and increases specificity for malignancy.

Diagnostic value of TROP-2 expression in papillary thyroid carcinoma and comparison with HBME-1, galectin-3 and cytokeratin 19

“…In the study by de Matos et al, as in our study, no staining was found in normal thyroid tissue [9]. Various studies demonstrated that Gal-3, in comparison to HBME-1 and CK19, has a higher sensitivity in distinguishing between benign and malignant lesions [7,12]. In our study, the sensitivity value of Gal-3 was lower than those of HBME-1 and CK19.…”

“…There are many studies demonstrating the positivity of Gal-3 in malignant lesions of thyroid, especially CVPTC [7,8,9,10,22]. Furthermore, positivity with varying frequencies was reported in different studies in benign thyroid nodules and lesions, follicular adenoma and FVPTC [7,8,9,10,12,22]. In our study, we did not observe staining with Gal-3 in NT tissue, and in FND and FA.…”

“…In Dunderovic et al's literature review, the researchers found the sensitivity and specificity of CK19 in distinguishing malignant and benign lesions as 80% and 78% respectively. These were respectively 74% and 77% in distinguishing FVPTC and FA [12]. In our study, these ratios were respectively 83.3% and 60% for distinguishing FND-FA and PTC, and 70% and 60% for distinguishing FND-FA and FVPTC.…”

“…Correct pathological diagnosis is necessary to minimize emotional stress, over-treatments and related financial costs brought by the diagnosis of thyroid cancer [3]. In order to eliminate disagreements among pathologists about well-differentiated lesions of thyroid derived from follicular epithelial cells and achieve diagnostic standardization, there have been many studies made where immunohistochemical and molecular markers are studied [4,5,6,7,8,9,10,11,12]. The immunohistochemical markers Hector Battifora mesothelial cell epitope-1 (HBME-1), galectin 3 (Gal-3) and cytokeratin 19 (CK19) accepted to be indicators of malignancy in thyroid lesions have been used as products of such studies as panels in most pathology laboratories.…”

Application of CK 19 and CD 56 Immunohistochemical Markers in the Diagnosis of Thyroid Tumors

“…[5] Upregulation of CK19 is connected with neoplastic transformation. [6] CD56 is a neural cell adhesion molecule (NCAM). [4] CD56 expression is markedly reduced by malignant transformation as previously reported in cases of FC, Anaplastic Carcinoma, and PC.…”