Galectin-3 and CD44v6 as Markers for Preoperative Diagnosis of Thyroid Cancer by RT-PCR

Abstract

The aim of the study was to determine the diagnostic value of reverse transcriptase polymerase chain reaction (RT-PCR) analysis of galectin-3 and CD44v6 as markers for preoperative diagnosis of malignancy in lesions of the thyroid. RT-PCR analysis of galectin-3 and CD44v6 expression was performed on RNA isolated from fine-needle aspirates of thyroid lesions from 428 patients. The results were evaluated against the postoperative histopathological diagnosis or definitive cytological diagnosis in cases of nodular goiter and Hashimoto thyroiditis. A total of 57 (13%) samples were inadequate for RT-PCR. Galectin-3 and CD44v6 were positive in 167 (45%) and 158 (43%) out of 371 adequate samples, respectively. Galectin-3 and CD44v6 were positive in 56 (86%) and 54 (83%) out of 65 papillary carcinomas, in 16 (29%) and 18 (32%) out of 56 Hashimoto's thyroiditis, in 61 (34%) and 52 (29%) out of 181 nodular goiters, in 23 (43%) and 23 (43%) out of 53 follicular adenomas, in 3 (100%) and 3 (100%) out of 3 follicular carcinomas, and in 8 (62%) and 8 (62%) out of 13 Hurthle cell adenomas, respectively. Specificity, sensitivity, and positive and negative predictive values in discriminating between malignant and benign thyroid nodules were 64, 87, and 35 and 96% for galectin-3; 67, 84, and 36 and 95% for CD44v6; and 79, 82, and 47 and 95% for the analysis of both markers (considered positive only if both galectin-3 and CD44v6 were positive), respectively. Owing to relatively low specificity, the clinical value of galectin-3 and CD44v6 analysis by RT-PCR as a marker for preoperative diagnosis of malignancy in thyroid lesions is limited.

Quantitative Analysis of Galectin-3 Expression in Benign and Malignant Thyroid Nodules

“…However, the diagnostic accuracy of galectin-3 in our study was limited, with a specificity of 50%, sensitivity of 88%, positive predictive value of 27%, and negative predictive value of 95%. The limited diagnostic accuracy shown in this study, mostly due to a high false positive rate, is in accordance with previous RT-PCR studies of galectin-3 expression in preoperative thyroid FNA samples ( 12 , 23 - 26 ). The high false positive rate of galectin-3 expression detected by PCR might be due to galectin-3 expression in other cells present in thyroid FNA samples in addition to thyroid epithelium cells.…”

“…Analysis of galectin-3 expression by reverse transcription polymerase chain reaction (RT-PCR) was performed in fewer studies with inconclusive results. In the largest prospective study of galectin-3 by RT-PCR, it showed high sensitivity and negative predictive value, but low specificity and positive predictive value as a marker for preoperative diagnosis of malignant thyroid lesions ( 12 ).…”

Combined staining for immunohistochemical markers in the diagnosis of papillary thyroid carcinoma: Improvement in the sensitivity or specificity?

“…26–28 Galectin-3 is expressed in a high proportion of PTC specimens and most likely plays a significant role in the malignant transformation of thyroid follicular cells. 29,30 Our current study found that the sensitivity of galectin-3 to detect PTC was 81.9%, just below that of CK-19, whereas the specificity was 92.3%, just below that of HBME-1.…”

Thyroid malignancy neoplasm-associated biomarkers as targets for oncolytic virotherapy

“…PTCs were significantly more often high expressers of CD44s and CD44v6 than FTC ( P <0.001 for both). Furthermore, it believed that the reduced level of CD44s seems to be an independent prognostic factor for unfavorable disease outcome 54,55…”