Utility of malignancy markers in fine-needle aspiration cytology of thyroid nodules: comparison of Hector Battifora mesothelial antigen-1, thyroid peroxidase and dipeptidyl aminopeptidase IV

Abstract

The purpose of this study was to compare the diagnostic interest of Hector Battifora mesothelial antigen-1 (HBME-1), thyroid peroxidase (TPO), and dipeptidyl aminopeptidase IV (DPP4) in thyroid fine-needle aspirates obtained from 200 resected thyroid lesions (55 colloid nodules, 54 follicular adenomas, 59 papillary cancers, and 32 follicular carcinomas). Hector Battifora mesothelial antigen-1 or TPO expression (% positive cells) and DPP4 staining score (12-point scale) were evaluated. Receiver operating characteristic (ROC) curves were plotted and optimal cutoff values for diagnosing malignancy were determined. The TPO ROC curve was consistently higher than the HBME-1 ROC curve. The TPO curve was also higher than the DPP4 curve with regard to sensitivity, but dipped below the DPP4 curve with regard to specificity. Using a cutoff value of o80% positive cells for TPO, 410% positive cells for HBME-1, and staining score X1 for DPP4, sensitivity to specificity ratios were 98 -83% for TPO, 90 -60% for HBME-1, and 88 -80% for DPP4. Two particularly interesting findings of this study were the low negative likelihood ratio of TPO (0.02) allowing highly reliable exclusion of malignancy and the 100% specificity of DPP4 staining scores ¼ 12. Due to poor performance on follicular lesions, HBME-1 showed no advantage over TPO or DPP4.

Diagnostic utility of immunohistochemical panel in various thyroid pathologies

“…This study was performed to evaluate the diagnostic values of HBME-1, COX-2, E-CAD, CD56, Anti-HBME-1, first described in 1992 by Battifora et al [10], is a monoclonal antibody directed against an antigen of the microvillous surface of mesothelioma cells [11]. In several studies on tissue samples and on FNA products, it has been found positive in thyroid malignancies, especially in PTC [12][13][14][15][16][17][18][19][20].…”

Application of Immunocytochemistry on Cell Block Sections for the Investigation of Thyroid Lesions

“…Lubitz and Fahey [39] reported positive immunoreactivity in 85% of follicular carcinomas, 97% of papillary carcinomas, and 27% of follicular adenomas. Positive immunoreactivity for HBME-1 is observed in benign thyroid lesions, but its expression is weak and focal in contrast to the strong and diffuse expression presented in malignant lesions [20,40]. …”

Recommandations de la Société française d’endocrinologie pour la prise en charge des nodules thyroïdiens

“…Si anesthésie locale utiliser 0,5 à1,5 ml de lidocaïne 1-2 % en injection souscutanée lente ou prescrire une pommade anesthésiante (type EMLA) faisant effet en une heure. [112,113] dont les protocoles sont les plus conformes aux standards internationaux en matière d'études de tests diagnostics [114]. Une analyse plus exhaustive des données de la littérature sur les marqueurs ICC en cytologie thyroïdienne peut être trouvée dans ces articles et la revue de Viehl et al [108].…”