Significance of AgNORs and Ki-67 Proliferative Markers in Differential Diagnosis of Thyroid Lesions

Abstract

We aimed to assess the utility of quantitative analysis of AgNORs and Ki67 labeling index (LI) in the differential diagnosis of different thyroid lesions. This study included: 25 papillary carcinomas, 7 follicular carcinomas, 21 follicular adenomas and 27 nodular goiters. Using a semiautomatic image analysis system, Ag NORs parameters were measured and calculated including: total area of AgNORs, mean Ag NOR number in nuclei, nuclear area, mean area of AgNOR dots per each nucleus, number of central and marginal AgNOR dots, and the relative ratio of total area of AgNOR dots/total area of nucleus. Ki67 immunostaining was performed and the LI was determined. There was a significant difference between groups of thyroid lesions regarding total area of AgNORs, Ag NOR number and number of marginal Ag NOR dots. According to receiver operating characteristic curve, Ag NORs number =2.91 and marginal Ag NORs = 2.67 were useful cut off values above which follicular carcinoma can be diagnosed with 100 % sensitivity, 79 % specificity, 76 % PPV, 100 % NPV and 85 % diagnostic accuracy for both parameters. Mean Ki67 LI in our study was 14.12 ± 2.29, 61.42 ± 3.77, 34.90 ± 3.49 and 18.60 ± 1.96 for papillary carcinoma, follicular carcinoma, follicular adenoma and nodular goiter respectively. Ki67 LI showed statistically significant difference between follicular carcinoma and follicular adenoma (p = 0.026) and between papillary carcinoma and follicular adenoma (p = 0.007). Quantification of Ag NORs and Ki67 LI could be used as helpful ancillary methods in the differentiation between different thyroid lesions.

Expression of Ki67 in Papillary Thyroid Microcarcinoma and its Clinical Significance

“…In this study, although the absolute value of expression intensity and positive rate of Ki67 in PTMC was not very high, the expression intensity was below 25%, but it had statistical significance with the differences between PTMC and benign lesions with papillary hyperplasia. Some study also confirmed that Ki67 expression is beneficial for the differential diagnosis of thyroid papillary carcinoma (Aiad et al, 2013).…”

Evaluation of the Long-term Growth Potential of Benign Non-toxic Thyroid Nodules by the AgNOR Method; an 11-year Follow-up Study

“…Since then, this finding has been confirmed by several other groups [22][23][24][25][26][27][28][29][30]. The widespread application of the technique has been hindered by the relatively wide overlap between AgNOR values of the benign and malignant groups [31].…”

Визначення Експресії Імуногістохімічних Маркерів Апоптозу Та Проліферації У Тканинах Фолікулярних Неоплазій Щитоподібної Залози

“…Індекс ПА як кількісний критерій досить активно застосовується в мамології при оцінці агресії злоякісного процесу. ПА пухлинних клітин при раку ЩЗ досить активно вивчається в країнах Західної Європи, США, Ро-сії та Японії [15]. Багато досліджень демонструють високий рівень експресії при злоякісній патології ЩЖ, зокрема при папілярному раку ЩЗ, а також як прогностично несприятливий фактор при ди-ференціальній діагностиці ФА і ФРЩЗ [16,17].…”