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Gao X, Zhang R, He Y, Wang X, Bao W, Feng X, Chai J, Wang J. EphB3 protein is a potential ancillary diagnostic biomarker for thyroid cancers. Ann Diagn Pathol 2024; 69:152262. [PMID: 38150866 DOI: 10.1016/j.anndiagpath.2023.152262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 12/21/2023] [Accepted: 12/21/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVE To investigate the expression of ephrin type B receptor 3 (EphB3) in thyroid tumors and its usage as an ancillary diagnostic biomarker for thyroid tumors. METHODS Formalin-fixed and paraffin-embedded (FFPE) tissue samples (78 cases) and FNAC samples (57 cases) were assessed with the EphB3 antibody using immunohistochemistry. PTC and other thyroid follicular tumors were compared regarding their EphB3 expression. Sanger sequencing was used to assess for the presence of a BRAF V600E mutation. RESULTS EphB3 was positive in 81.8 % (27/33) of papillary thyroid carcinoma (PTC), 83.3 % (5/6) of medullary thyroid carcinoma (MTC), 25 % (1/4) of hyperplastic/adenomatoid nodule (HN), 14.3 % (1/7) of follicular adenoma (FA), and negative in follicular tumors of uncertain malignant potential (FT-UMP) (0/13), noninvasive follicular neoplasm with papillary-like nuclear features (NIFTP) (0/7), thyroid follicular carcinoma (TFC) (0/4), Hashimoto's thyroiditis (0/4), and normal thyroid follicular tissues (0/33). In cellular blocks, EphB3 was positive in 87.1 % (20/23) of PTC, 75 % (3/4) of MTC, 20 % (2/10) of HN, and negative in atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS) (0/20) and normal thyroid follicular cells (0/10). CONCLUSION EphB3 is expressed in the majority of PTC, but less so in benign follicular nodules. EphB3 expression in fine needle aspiration cytology (FNAC) specimens can be used as a diagnostic tool to differentiate thyroid cancer from other follicular lesions in its differential diagnosis, especially AUS/FLUS and PTC.
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Affiliation(s)
- Xinyue Gao
- Department of Pathology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China
| | - Rusong Zhang
- Department of Pathology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China
| | - Yan He
- Department of Pathology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China
| | - Xuan Wang
- Department of Pathology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China
| | - Wei Bao
- Department of Pathology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China
| | - Xiao Feng
- Department of Pathology, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China
| | - Jiaxin Chai
- Department of Pathology Eastern Theater Air Force Hospital, No. 1 Nanjing Ma Lu Jie, Nanjing 120002, China
| | - Jiandong Wang
- Department of Pathology, Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210002, China.
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Li X, Cheng R. TPO as an indicator of lymph node metastasis and recurrence in papillary thyroid carcinoma. Sci Rep 2023; 13:10848. [PMID: 37407700 DOI: 10.1038/s41598-023-37932-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 06/29/2023] [Indexed: 07/07/2023] Open
Abstract
The objective of this study was to investigate the expression of thyroid peroxidase (TPO) in papillary thyroid carcinoma (PTC) and to preliminarily investigate its value as a marker of lymph node metastasis and recurrence in patients with PTC. Clinical data of PTC patients and TPO expression were collected from The Cancer Genome Atlas (TCGA) database for analysis. We recruited 230 consecutive PTC patients from the Department of Thyroid Surgery of the First Affiliated Hospital of Kunming Medical University, collected their clinicopathological data, and also performed immunohistochemical analysis of TPO expression on their thyroid specimens to validate the results of bioinformatics analysis. In addition, the construction of protein-protein interaction networks was performed too. Functional enrichment analysis and immuno-infiltration analysis characterized the pathways in which TPO genes may be involved. Data mining based on the TCGA database showed that TPO expression in PTC tissues was significantly lower than in paired normal thyroid tissues. The expression level of TPO in PTC tissues correlated with tumor lymph node metastasis and recurrence. Follow-up data from our center also validated the difference in TPO expression and its relationship with lymph node metastasis in PTC patients. Functional enrichment analysis showed that TPO function was significantly associated with signaling pathways related to amino acid metabolism, gene expression regulation and tumorigenesis. TPO expression was also significantly associated with immune infiltration. Our study showed that reduced TPO expression was significantly associated with lymph node metastasis and recurrence in patients with PTC, and we validated this result in our central cohort. These data suggest that TPO may serve as a prognostic indicator for PTC.
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Affiliation(s)
- Xiang Li
- Department of Thyroid Surgery, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan, China
| | - Ruochuan Cheng
- Department of Thyroid Surgery, The First Affiliated Hospital of Kunming Medical University, No. 295, Xichang Road, Kunming, 650032, Yunnan, China.
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3
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Bansal R, Saxena U. Integrative Analysis of Potential Biomarkers Involved in the Progression of Papillary Thyroid Cancer. Appl Biochem Biotechnol 2022; 195:2917-2932. [PMID: 36445679 DOI: 10.1007/s12010-022-04244-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2022] [Indexed: 11/30/2022]
Abstract
This study aims to explore key prognostic and diagnostic biomarkers involved in the pathogenesis of papillary thyroid cancer (PTC) which is one of the most common endocrine cancers and whose occurrence is rapidly increasing. Papillary thyroid cancer datasets containing normal and tumor samples were collected from Gene Expression Omnibus. Protein-protein interaction (PPI) network for common upregulated differentially expressed genes (DEGs) was constructed, and hub genes were studied. Gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were performed to identify the vital biological behaviors and pathways involved in PTC. PPI network analysis demonstrated the interaction between 134 common upregulated DEGs, and top 15 pivotal genes with highest degree of connectivity were retrieved. Three of the hub genes (DPP4, ITGA2, FN1) were linked to the prognosis of PTC patients and considered clinically relevant core genes via survival analysis. We suggest that the identification of key genes associated with PTC development help us in understanding molecular mechanisms related to disease. These genes could also be considered the diagnostic biomarkers or as therapeutic targets in the future treatment for PTC.
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Affiliation(s)
- Ritu Bansal
- Department of Biotechnology, National Institute of Technology Warangal, Warangal, 506004, Telangana, India
| | - Urmila Saxena
- Department of Biotechnology, National Institute of Technology Warangal, Warangal, 506004, Telangana, India.
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4
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Mohan U, Sunny SP, Mendonca P, Kuriakose MA, Kannan S, Suresh A. Systematic Review and Meta-Analysis to Identify the Immunocytochemical Markers Effective in Delineating Benign from Malignant Thyroid Lesions in FNAC Samples. Endocr Pathol 2022; 33:243-256. [PMID: 35596875 DOI: 10.1007/s12022-022-09721-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/03/2022]
Abstract
Conventional cytology-based diagnosis for thyroid cancer is limited with more than 30-45% of nodules categorized as indeterminate, necessitating surgery for confirming or refuting the diagnosis. This systematic review and meta-analysis were aimed at identifying immunocytochemical markers effective in delineating benign from malignant thyroid lesions in fine needle aspiration cytology (FNAC) samples, thereby improving the accuracy of cytology diagnosis. A systematic review of relevant articles (2000-2021) from online databases was carried out and the search protocol registered in PROSPERO database (CRD42021229121). The quality of studies was assessed using QUADAS-2. Review Manager 5.4.1 from Cochrane collaboration and MetaDisc Version 1.4 was used to conduct the meta-analysis. Bias in the studies were visually analyzed using funnel plots, and statistical significance was evaluated by Egger's test. Systematic review identified 64 original articles, while meta-analysis in eligible articles (n = 41) identified a panel of 5 markers, Galectin-3, HBME-1, CK-19, CD-56, and TPO. Assessment of the diagnostic performance revealed that Gal-3 (sensitivity: 0.81; CI: 0.79-0.83; specificity: 0.84; CI: 0.82-0.85) and HBME-1 (sensitivity: 0.83; Cl: 0.81-0.86; specificity: 0.85; CI: 0.83-0.86) showed high accuracy in delineating benign from malignant thyroid nodules. Efficacy analysis in indeterminate nodules showed Gal-3 and HBME-1 have high specificity of 0.86 (CI 0.84-0.89) and 0.82 (CI 0.78-0.86), respectively, and low sensitivity of 0.76 (CI 0.72-0.80) and 0.75 (CI 0.70-0.80), respectively. Diagnostic odds ratio (DOR) of Galectin-3 and HBME-1 were 39.18 (CI 23.38-65.65) and 24.44 (CI 11.16-53.54), respectively. Significant publication bias was observed for the markers Galectin-3 and CK-19 (p < 0.05). The panel of 5 markers identified from this meta-analysis are high-confidence candidates that need to be validated in thyroid cytology to establish their efficacy and enable clinical applicability.
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Affiliation(s)
- Uma Mohan
- Department of Head and Neck Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore, India
- Integrated Head and Neck Oncology Program, DSRG-5, Mazumdar Shaw Center for Translational Research, Mazumdar Shaw Medical Foundation, Bangalore, India
| | - Sumsum P Sunny
- Department of Head and Neck Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore, India
- Integrated Head and Neck Oncology Program, DSRG-5, Mazumdar Shaw Center for Translational Research, Mazumdar Shaw Medical Foundation, Bangalore, India
| | - Pramila Mendonca
- Department of Head and Neck Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore, India
- Integrated Head and Neck Oncology Program, DSRG-5, Mazumdar Shaw Center for Translational Research, Mazumdar Shaw Medical Foundation, Bangalore, India
| | - Moni A Kuriakose
- Department of Head and Neck Oncology, Mazumdar Shaw Medical Center, NH Health City, Bangalore, India
- Integrated Head and Neck Oncology Program, DSRG-5, Mazumdar Shaw Center for Translational Research, Mazumdar Shaw Medical Foundation, Bangalore, India
| | - Subramanian Kannan
- Department of Endocrinology, Mazumdar Shaw Medical Center, NH Health City, Bangalore, India
| | - Amritha Suresh
- Integrated Head and Neck Oncology Program, DSRG-5, Mazumdar Shaw Center for Translational Research, Mazumdar Shaw Medical Foundation, Bangalore, India.
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Ismail MS, Mousa AMAG, Darwish MF, Salem MM, Said R. Expression of β-Catenin in Thyroid Neoplasms (Histopathological and Immunohistochemical Study). Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Thyroid cancer is the most common malignant tumor of the endocrine system accounting for more than 90% of all endocrine cancer and 63% of all endocrine cancer deaths. β-catenin is a multifunctional protein that plays a key role in Wnt (wingless type) pathway and influences the expression of different genes and their proliferation, thus making it a potential therapeutic target.
Aim of Work: This work aimed to examine immunohistochemical expression of β-catenin in different cases of thyroid neoplasms and to correlate between β-catenin expression and clinicopathological features of these thyroid neoplasms.
Methods: This retrospective study was conducted on sixty cases of archived, formalin fixed, paraffin embedded tissue blocks that included different histologic types of thyroid neoplasms. Immunohistochemistry using β-catenin monoclonal antibody was performed using a standard avidin-biotin-peroxidase system. β-catenin expression was quantified both at membranous and cytoplasmic level. Immunostaining scores were based on the staining intensity (I) and the percentage of positive cells (P). β-catenin final score (H score) resulted by summation of I and P (ranging from 0 to 7). Cases with H score between 1–3 were considered with low score and cases with H score between 4–7 were considered with high score.
Results: Of the malignant thyroid neoplasms in the studied cases, 81% showed positive β-catenin expression with the majority (86%) of the benign thyroid cases showing positive expression. Both membranous and cytoplasmic staining were both assessed in which the majority of the negative and high positive membranous cases also showed the same interpretation for cytoplasmic β-catenin expression. Positive correlations were proved between β-catenin expression of diagnosed malignant cases, (pvalue =0.042) where all hurthle cell, follicular and medullary carcinoma cases, 87.5% of studied papillary carcinoma cases and 50% of poorly differentiated carcinoma cases showed β-catenin positivity while all anaplastic carcinoma cases were negative. Furthermore, statistically significant findings were seen in cases with absence of extrathyroid extension (P value= 0.045) especially those displaying β-Catenin cytoplasmic expression with extrathyroid extension of studied malignant cases showing a P value= (0.011) . No significant correlation was found between β-catenin expression and patients' pathological diagnosis, gender, extent of primary tumor (pT), lymph node metastasis, multifocality and co-existing pathology among studied malignant cases.
Conclusion: The present study suggests the prognostic role of β-catenin and its possible usage to identify patients who may benefit from adjuvant β-catenin targeted mono- or combined therapy for tumors expressing this protein, especially for thyroid cases that cannot be removed surgically or that do not respond to traditional treatment options.
Key Words: β-catenin, immunohistochemistry, malignant thyroid neoplasms, benign thyroid neoplasms.
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Gomaa SH, Abaza MM, Elattar HA, Amin GA, Elshahawy DM. Soluble cluster of differentiation 26/soluble dipeptidyl peptidase-4 and glypican-3 are promising serum biomarkers for the early detection of Hepatitis C virus related hepatocellular carcinoma in Egyptians. Arab J Gastroenterol 2020; 21:224-232. [PMID: 32891543 DOI: 10.1016/j.ajg.2020.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 02/05/2020] [Accepted: 04/19/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND STUDY AIMS Many patients are diagnosed with hepatocellular carcinoma (HCC) in the late stage when it is already untreatable. Therefore, there is an increased need for sensitive biomarkers to detect HCC at an earlier stage in high risk patients with hepatitis C virus (HCV)-induced cirrhosis. This study aimed to evaluate the diagnostic performance of soluble cluster of differentiation 26/dipeptidyl peptidase 4 (sCD26/sDPP4) and glypican-3 (GPC3) as serum biomarkers for the early detection of HCV related HCC and compare it with that of the conventional tumor marker serum alpha fetoprotein (AFP). PATIENTS AND METHODS The study included 80 participants, 30 patients diagnosed with HCV infection without HCC (HCV group), 30 patients diagnosed with HCV- related HCC (HCV group), and 20 healthy volunteers (control group). The serum levels of GPC3 and sCD26 were measured using specific enzyme linked immunosorbant assay (ELISA) kits, whereas AFP levels were determined using chemiluminescence. RESULTS The serum levels of both sCD26 and GPC3 were found to be significantly higher in patients with early-stage HCC than in the HCV group, (1450 and 1.16 ng/mL, respectively). sCD26 at a cutoff value of > 1000 ng/ml, showed a high sensitivity (83.3%) and 63.3% specificity with an area under curve (AUC) of 0.811 and a 95% confidence interval (CI) of (0.682-0.94). While, the combination of GPC3 and sCD26 exhibited the best diagnostic performance for early-stage-HCC because it increased the sensitivity and specificity (85% and 93.3% respectively), with an AUC of 0.986 and a 95% CI of (0.899-1.00) compared to sCD26 alone. CONCLUSION We conclude that serum sCD26 could be a sensitive biomarker for the early detection of HCC among HCV patients. Moreover, the combination of sCD26 and GPC3 increases both the sensitivity and specificity for the early detection of HCV related HCC compared with AFP and could help in the monitoring of HCC in high risk patients with HCV induced cirrhosis.
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Affiliation(s)
- Salwa H Gomaa
- Department of Chemical Pathology, Medical Research Institute, Alexandria University, Egypt.
| | - Mona M Abaza
- Department of Chemical Pathology, Medical Research Institute, Alexandria University, Egypt
| | - Hoda A Elattar
- Department of Chemical Pathology, Medical Research Institute, Alexandria University, Egypt
| | - Gamal A Amin
- Department of Experimental and Internal Medicine, Medical Research Institute, Alexandria University, Egypt
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7
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Enz N, Vliegen G, De Meester I, Jungraithmayr W. CD26/DPP4 - a potential biomarker and target for cancer therapy. Pharmacol Ther 2019; 198:135-159. [PMID: 30822465 DOI: 10.1016/j.pharmthera.2019.02.015] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
CD26/dipeptidyl peptidase (DPP)4 is a membrane-bound protein found in many cell types of the body, and a soluble form is present in body fluids. There is longstanding evidence that various primary tumors and also metastases express CD26/DPP4 to a variable extent. By cleaving dipeptides from peptides with a proline or alanine in the penultimate position at the N-terminus, it regulates the activity of incretin hormones, chemokines and many other peptides. Due to these effects and interactions with other molecules, a tumor promoting or suppressing role can be attributed to CD26/DPP4. In this review, we discuss the existing evidence on the expression of soluble or membrane-bound CD26/DPP4 in malignant diseases, along with the most recent findings on CD26/DPP4 as a therapeutic target in specific malignancies. The expression and possible involvement of the related DPP8 and DPP9 in cancer are also reviewed. A higher expression of CD26/DPP4 is found in a wide variety of tumor entities, however more research on CD26/DPP4 in the tumor microenvironment is needed to fully explore its use as a tumor biomarker. Circulating soluble CD26/DPP4 has also been studied as a cancer biomarker, however, the observed decrease in most cancer patients does not seem to be cancer specific. Encouraging results from experimental work and a recently reported first phase clinical trial targeting CD26/DPP4 in mesothelioma, renal and urological tumors pave the way for follow-up clinical studies, also in other tumor entities, possibly leading to the development of more effective complementary therapies against cancer.
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Affiliation(s)
- Njanja Enz
- Department of Thoracic Surgery, University Hospital Rostock, Schillingallee 35, 18057 Rostock, Germany
| | - Gwendolyn Vliegen
- Laboratory of Medical Biochemistry, Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium
| | - Ingrid De Meester
- Laboratory of Medical Biochemistry, Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
| | - Wolfgang Jungraithmayr
- Department of Thoracic Surgery, University Hospital Rostock, Schillingallee 35, 18057 Rostock, Germany.
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8
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Ergün S, Akıncı O, Öztürk T, Karataş A. Hyalinizing trabecular tumor of the thyroid gland. Turk J Surg 2018; 34:149-151. [PMID: 30023983 DOI: 10.5152/ucd.2017.3221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/10/2015] [Indexed: 11/22/2022]
Abstract
Hyalinizing trabecular tumor was first described by Carney et al. (1) in 1987 and is a rare benign tumor of the thyroid gland that shares some of the microscopic features of medullary and papillary thyroid carcinoma. Hyalinizing trabecular tumor derives from follicular cells, and it is characterized by an apparent trabecular pattern and intratrabecular hyalinization. In this study, we present the case of a 40-year-old female patient with thyroid gland nodules, whose ultrasound results, clinical behavior, and fine-needle aspiration biopsy results were suspicious; the pathology after thyroidectomy indicated hyalinizing trabecular tumor. We aimed to show the role of clinical behavior, radiology, fine-needle aspiration, and histological and immunohistochemical analysis in the differential diagnosis of hyalinizing trabecular tumor. Hyalinizing trabecular tumor which can be confused with papillary and medullar carcinoma of the thyroid gland, is mostly benign but some malignant and metastatic cases have been reported. Therefore, diagnosis, treatment, and follow-up steps of Hyalinizing trabecular tumor should be planned in consideration of a malignant potential.
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Affiliation(s)
- Sefa Ergün
- Department of General Surgery, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Ozan Akıncı
- Department of General Surgery, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Tülin Öztürk
- Department of Clinical Pathology, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Adem Karataş
- Department of General Surgery, İstanbul University Cerrahpaşa School of Medicine, İstanbul, Turkey
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Bode-Lesniewska B, Cochand-Priollet B, Straccia P, Fadda G, Bongiovanni M. Management of thyroid cytological material, preanalytical procedures and bio-banking. Cytopathology 2018; 30:7-16. [DOI: 10.1111/cyt.12586] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2018] [Indexed: 12/29/2022]
Affiliation(s)
- B. Bode-Lesniewska
- Institute of Pathology and Molecular Pathology; University Hospital Zurich; Zurich Switzerland
| | - B. Cochand-Priollet
- Department of Pathology; Faculté Paris Descartes; Cochin Hospital; APHP; Paris France
| | - P. Straccia
- Division of Anatomic Pathology and Histology; Catholic University of Sacred Heart; Foundation “Agostino Gemelli” University Hospital; Rome Italy
| | - G. Fadda
- Division of Anatomic Pathology and Histology; Catholic University of Sacred Heart; Foundation “Agostino Gemelli” University Hospital; Rome Italy
| | - M. Bongiovanni
- Service of Clinical Pathology; Institute of Pathology; Lausanne University Hospital; Lausanne Switzerland
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10
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Margari N, Giovannopoulos I, Pouliakis A, Mastorakis E, Gouloumi AR, Panayiotides IG, Karakitsos P. Application of Immunocytochemistry on Cell Block Sections for the Investigation of Thyroid Lesions. Acta Cytol 2018; 62:137-144. [PMID: 29339640 DOI: 10.1159/000485824] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 11/29/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To investigate the potential of Classification and Regression Trees (CARTs) for the diagnosis of thyroid lesions based on cell block immunocytochemistry and cytological outcome. STUDY DESIGN A total of 956 histologically confirmed cases (673 benign and 283 malignant) from patients with thyroid nodules were prepared via liquid-based cytology and evaluated; 4 additional slides were stained for cytokeratin 19 (CK-19), galectin 3 (Gal-3), Hector Battifora mesothelial cell 1 (HBME-1), and thyroglobulin. On the basis of immunocytochemistry and the cytological diagnosis, a CART algorithm was constructed and used for evaluation. RESULTS The major important factors contributing to the diagnostic CART model were: cytological outcome, CK-19, Gal-3, and HBME-1. The sensitivity and specificity of the cytological diagnosis were 96.27% and 88.26%, respectively (cut-off: category 3 of The Bethesda System [TBS-3]). The introduction of immunocytochemistry and the CART model increased the sensitivity and specificity to 98.88% and 99.11%, respectively. CK-19 presented the best performance for discriminating papillary thyroid carcinomas, followed by HBME-1 and Gal-3. In the TBS-2 cases, CK-19 and, subsequently, Gal-3 were important immunocytochemistry markers. Ultimately, CK-19 and HBME-1 on TBS-5 or TBS-6 cases demonstrated the best results. CONCLUSIONS The hierarchical structure of the CART model provides a diagnostic algorithm linked with the risk of malignancy at every step of the procedure. It also provides guidance on the use of ancillary examinations as it goes by simple, human understandable rules.
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Affiliation(s)
- Niki Margari
- Second Department of Pathology, University of Athens, School of Medicine, "Attikon" University Hospital, Athens, Greece
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11
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Arcolia V, Journe F, Renaud F, Leteurtre E, Gabius HJ, Remmelink M, Saussez S. Combination of galectin-3, CK19 and HBME-1 immunostaining improves the diagnosis of thyroid cancer. Oncol Lett 2017; 14:4183-4189. [PMID: 28943926 PMCID: PMC5592881 DOI: 10.3892/ol.2017.6719] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 06/26/2017] [Indexed: 12/21/2022] Open
Abstract
Currently, fine-needle aspiration is the most frequently used pre-operative technique for diagnosis of malignant thyroid tumors, however, pathologists are unable to reach efficient and accurate differential diagnoses between benign and malignant thyroid nodules. To aid in resolving this issue, immunohistochemistry for galectins (gal)-1, −3, −7, −8, cytokeratin 19 (CK19), Hector Battifora Mesothelial Epitope-1 (HBME-1) and thyroid peroxidase (TPO) was performed on two tissue microarrays composed of 66 follicular adenomas (FA) and 66 papillary carcinomas (PC). The identification of optimal cut-off levels and the diagnostic value of single immunomarkers or combinations were evaluated using the receiver operating characteristic curve analysis. Signal intensities for gal-1, gal-3, CK19 and HBME-1 were significantly greater in PC compared with FA (P<0.001). Conversely, expression levels of TPO were significantly increased in FA compared with PC (P<0.001). Gal-3 and CK19 appeared to be the most sensitive markers (97 and 98%, respectively), whereas galectin-1 was the most specific (97%). The combination of gal-3, CK19 and HBME-1 acted as the most efficient and informative marker panel reaching the greatest specificity (97%) and sensitivity (95%) for the diagnosis of PCs. The findings suggest that this combination of markers may improve the reliability of diagnosis of thyroid cancer.
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Affiliation(s)
- Vanessa Arcolia
- Laboratory of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, B-7000 Mons, Belgium
| | - Fabrice Journe
- Laboratory of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, B-7000 Mons, Belgium.,Laboratory of Oncology and Experimental Surgery, Jules Bordet Institute, Free University of Brussels, B-1000 Brussels, Belgium
| | - Florence Renaud
- Lille University, UMR-S 1172, JPARC, Jean-Pierre Aubert Research Center, F-59000 Lille, France
| | - Emmanuelle Leteurtre
- Lille University, UMR-S 1172, JPARC, Jean-Pierre Aubert Research Center, F-59000 Lille, France
| | - Hans-Joachim Gabius
- Institute of Physiological Chemistry, Faculty of Veterinary Medicine, Ludwig-Maximilians-University, D-80539 Munich, Germany
| | - Myriam Remmelink
- Department of Pathology, Erasme Hospital, Free University of Brussels, B-1070 Brussels, Belgium
| | - Sven Saussez
- Laboratory of Human Anatomy and Experimental Oncology, Faculty of Medicine and Pharmacy, University of Mons, B-7000 Mons, Belgium.,Department of Oto-Rhino-Laryngology, CHU Saint-Pierre, Free University of Brussels, B-1000 Brussels, Belgium
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Lee JJ, Wang TY, Liu CL, Chien MN, Chen MJ, Hsu YC, Leung CH, Cheng SP. Dipeptidyl Peptidase IV as a Prognostic Marker and Therapeutic Target in Papillary Thyroid Carcinoma. J Clin Endocrinol Metab 2017; 102:2930-2940. [PMID: 28575350 DOI: 10.1210/jc.2017-00346] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/23/2017] [Indexed: 12/18/2022]
Abstract
CONTEXT Dipeptidyl peptidase IV (DPP4) is overexpressed in thyroid cancer and certain malignancies. Furthermore, DPP4 has been identified as a discriminatory marker for thyroid cancer. However, it remains unclear whether DPP4 expression plays a prognostic role. OBJECTIVE The aim of this study was to investigate the expression and function of DPP4 in thyroid cancer and the mechanisms involved. DESIGN We determined the expression of DPP4 by immunohistochemistry in tissue microarrays of thyroid tumors. In vitro functional studies were performed after genetic and pharmacological inhibition of DPP4. Gene expression and pathway analyses were used to identify downstream targets. The therapeutic potential of DPP4 inhibition was evaluated in a mouse xenograft model. RESULTS High DPP4 expression was associated with extrathyroidal extension (P < 0.001), BRAF mutation (P < 0.001), and advanced tumor stage (P = 0.007) in papillary thyroid cancer. Patients in the high-DPP4 expression group were less likely to be classified as having no evidence of disease at final follow-up (P = 0.042). DPP4 silencing or treatment with DPP4 inhibitors significantly suppressed colony formation, cell migration, and invasion. Analysis of differentially expressed genes after DPP4 knockdown suggested that the transforming growth factor-β signaling pathway is involved. In vivo experiments revealed that sitagliptin treatment reduced tumor growth and xenograft transforming growth factor-β receptor I expression. CONCLUSIONS Increased DPP4 expression is associated with cellular invasion and more aggressive disease in papillary thyroid cancer. Targeting DPP4 may be a therapeutic strategy for DPP4-expressing thyroid cancer.
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Affiliation(s)
- Jie-Jen Lee
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan
- Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei 11031, Taiwan
| | - Tao-Yeuan Wang
- Department of Pathology, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan
| | - Chien-Liang Liu
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan
| | - Ming-Nan Chien
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan
| | - Ming-Jen Chen
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan
- Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei 11031, Taiwan
| | - Yi-Chiung Hsu
- Department of Biomedical Sciences and Engineering, National Central University, Taoyuan City 32001, Taiwan
| | - Ching-Hsiang Leung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan
| | - Shih-Ping Cheng
- Department of Surgery, MacKay Memorial Hospital and Mackay Medical College, Taipei 10449, Taiwan
- Graduate Institute of Medical Sciences and Department of Pharmacology, Taipei Medical University, Taipei 11031, Taiwan
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Heikkilä A, Fermér C, Hagström J, Louhimo J, Mäenpää H, Siironen P, Heiskanen I, Nilsson O, Arola J, Haglund C. A novel stem cell associated marker identified by monoclonal antibody HESC5:3 differentiates between neoplastic lesions in follicular thyroid neoplasms. APMIS 2015; 123:604-12. [DOI: 10.1111/apm.12393] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Accepted: 03/05/2015] [Indexed: 12/11/2022]
Affiliation(s)
- Annukka Heikkilä
- Department of Pathology; Haartman Institute and HUSLAB; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | | | - Jaana Hagström
- Department of Pathology; Haartman Institute and HUSLAB; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Johanna Louhimo
- Department of Surgery; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Hanna Mäenpää
- Department of Oncology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Päivi Siironen
- Department of Surgery; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Ilkka Heiskanen
- Department of Surgery; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | | | - Johanna Arola
- Department of Pathology; Haartman Institute and HUSLAB; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Caj Haglund
- Department of Pathology; Haartman Institute and HUSLAB; University of Helsinki and Helsinki University Hospital; Helsinki Finland
- Department of Surgery; University of Helsinki and Helsinki University Hospital; Helsinki Finland
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14
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Abstract
Context
Accurate classification of follicular-patterned thyroid lesions is not always an easy task on routine surgical hematoxylin-eosin–stained or cytologic fine-needle aspiration specimens. The diagnostic challenges are partially due to differential diagnostic criteria that are often subtle and subjective. In the past decades, tremendous advances have been made in molecular gene profiling of tumors and diagnostic immunohistochemistry, aiding in diagnostic accuracy and proper patient management.
Objective
To evaluate the diagnostic utility of the most commonly studied immunomarkers in the field of thyroid pathology by review of the literature, using the database of indexed articles in PubMed (US National Library of Medicine) from 1976–2013.
Data Sources
Literature review, authors' research data, and personal practice experience.
Conclusions
The appropriate use of immunohistochemistry by applying a panel of immunomarkers and using a standardized technical and interpretational method may complement the morphologic assessment and aid in the accurate classification of difficult thyroid lesions.
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Affiliation(s)
- Haiyan Liu
- From the Department of Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania
| | - Fan Lin
- From the Department of Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania
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15
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Maruta J, Hashimoto H, Yamashita H, Noguchi H, Noguchi S, Kobayashi TK, Tsuneoka H, Takahashi M. Value of thyroid specific peroxidase and Ki-67 stains in preoperative cytology for thyroid follicular tumors. Diagn Cytopathol 2014; 43:202-9. [DOI: 10.1002/dc.23204] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 07/17/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Junko Maruta
- Department of Pathology; The Noguchi Thyroid Hospital and Foundation; Oita Japan
- Department of Laboratory Science; Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine; Yamaguchi Japan
| | - Hironobu Hashimoto
- Department of Pathology; The Noguchi Thyroid Hospital and Foundation; Oita Japan
| | - Hiroto Yamashita
- Department of Pathology; The Noguchi Thyroid Hospital and Foundation; Oita Japan
| | - Hitoshi Noguchi
- Department of Internal Medicine; The Noguchi Thyroid Hospital and Foundation; Oita Japan
| | - Shiro Noguchi
- Department of Surgery; The Noguchi Thyroid Hospital and Foundation; Oita Japan
| | - Tadao K. Kobayashi
- Cancer Education and Research Center; Osaka University Graduate School of Medicine and Health Science; Osaka Japan
| | - Hidehiro Tsuneoka
- Department of Laboratory Science; Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine; Yamaguchi Japan
| | - Mutsuo Takahashi
- Department of Administration; Mine City Hospital; Yamaguchi Japan
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16
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Altered peptidase activities in thyroid neoplasia and hyperplasia. DISEASE MARKERS 2013; 35:825-32. [PMID: 24379520 PMCID: PMC3860089 DOI: 10.1155/2013/970736] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Revised: 09/29/2013] [Accepted: 10/01/2013] [Indexed: 12/02/2022]
Abstract
Background. Papillary thyroid carcinoma (PTC), follicular thyroid adenoma (FTA), and thyroid nodular hyperplasia (TNH) are the most frequent diseases of the thyroid gland. Previous studies described the involvement of dipeptidyl-peptidase IV (DPPIV/CD26) in the development of thyroid neoplasia and proposed it as an additional tool in the diagnosis/prognosis of these diseases. However, very little is known about the involvement of other peptidases in neoplastic and hyperplastic processes of this gland. Methods. The catalytic activity of 10 peptidases in a series of 30 PTC, 10 FTA, and 14 TNH was measured fluorimetrically in tumour and nontumour adjacent tissues. Results. The activity of DPPIV/CD26 was markedly higher in PTC than in FTA, TNH, and nontumour tissues. Aspartyl aminopeptidase (AspAP), alanyl aminopeptidase (AlaAP), prolyl endopeptidase, pyroglutamyl peptidase I, and aminopeptidase B activities were significantly increased in thyroid neoplasms when compared to nontumour tissues. AspAP and AlaAP activities were also significantly higher in PTC than in FTA and TNH. Conclusions. These data suggest the involvement of DPPIV/CD26 and some cytosolic peptidases in the neoplastic development of PTC and FTA. Further studies will help to define the possible clinical usefulness of AlaAP and AspAP in the diagnosis/prognosis of thyroid neoplasms.
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Khan MI, Laufgraben MJ. Molecular markers in thyroid cytology: diagnostic and prognostic implications. Expert Rev Endocrinol Metab 2013; 8:439-448. [PMID: 30754188 DOI: 10.1586/17446651.2013.827385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The discovery of thyroid nodules in the general population has risen markedly with the greater use of ultrasound resulting in increasing use of ultrasound-guided fine needle aspiration (FNA) biopsy. Although FNA can identify the majority of nodules as either benign or malignant, one-third of aspirates demonstrate indeterminate cytologic characteristics. Though most of these nodules will be pathologically benign, thyroid surgery has usually been needed to make an accurate diagnosis, and the extent of surgery needed (lobectomy versus total thyroidectomy) is difficult to predict in advance. New molecular techniques are being investigated and used clinically to improve decision making in patients with thyroid nodules with indeterminate cytology. These molecular markers have the potential to help clinicians decide which patients may be monitored without thyroid surgery, and also the optimal strategy when surgery is felt to be necessary.
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Affiliation(s)
- Maryam I Khan
- a Division of Endocrinology, Diabetes and Metabolism, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, NJ 08103, USA
| | - Marc J Laufgraben
- a Division of Endocrinology, Diabetes and Metabolism, Cooper Medical School of Rowan University, Cooper University Health Care, Camden, NJ 08103, USA
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18
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de Matos LL, Del Giglio AB, Matsubayashi CO, de Lima Farah M, Del Giglio A, da Silva Pinhal MA. Expression of CK-19, galectin-3 and HBME-1 in the differentiation of thyroid lesions: systematic review and diagnostic meta-analysis. Diagn Pathol 2012; 7:97. [PMID: 22888980 PMCID: PMC3523001 DOI: 10.1186/1746-1596-7-97] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 08/06/2012] [Indexed: 02/07/2023] Open
Abstract
Background To distinguish between malignant and benign lesions of the thyroid gland histological demonstration is often required since the fine-needle aspiration biopsy method applied pre-operatively has some limitations. In an attempt to improve diagnostic accuracy, markers using immunocytochemistry and immunohistochemistry techniques have been studied, mainly cytokeratin-19 (CK-19), galectin-3 (Gal-3) and Hector Battifora mesothelial-1 (HBME-1). However, current results remain controversial. The aim of the present article was to establish the diagnostic accuracy of CK-19, Gal-3 and HBME-1 markers, as well as their associations, in the differentiation of malignant and benign thyroid lesions. Methods A systematic review of published articles on MEDLINE and The Cochrane Library was performed. After establishing inclusion and exclusion criteria, 66 articles were selected. The technique of meta-analysis of diagnostic accuracy was employed and global values of sensitivity, specificity, area under the summary ROC curve, and diagnostic odds ratio (dOR) were calculated. Results For the immunohistochemistry technique, the positivity of CK-19 for the diagnosis of malignant thyroid lesions demonstrated global sensitivity of 81% and specificity of 73%; for Gal-3, sensitivity of 82% and specificity of 81%; and for HBME-1, sensitivity of 77% and specificity of 83%. The association of the three markers determined sensitivity of 85%, specificity of 97%, and diagnostic odds ratio of 95.1. Similar results were also found for the immunocytochemistry assay. Conclusion This meta-analysis demonstrated that the three immunomarkers studied are accurate in pre- and postoperative diagnosis of benign and malignant thyroid lesions. Nevertheless, the search for other molecular markers must continue in order to enhance this diagnostic accuracy since the results found still show a persistency of false-negative and false-positive tests. Virtual slides Http://www.diagnosticpathology.diagnomx.eu/vs/3436263067345159
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19
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Prasad NB, Kowalski J, Tsai HL, Talbot K, Somervell H, Kouniavsky G, Wang Y, Dackiw AP, Westra WH, Clark DP, Libutti SK, Umbricht CB, Zeiger MA. Three-gene molecular diagnostic model for thyroid cancer. Thyroid 2012; 22:275-84. [PMID: 22280184 PMCID: PMC3286810 DOI: 10.1089/thy.2011.0169] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND The preoperative diagnosis of thyroid nodules primarily depends upon fine needle aspiration (FNA) cytology. However, up to 25% of FNA samples have associated "suspicious or indeterminate", but not diagnostic cytologic reports, resulting in difficulty deciding appropriate clinical management for these patients. We hypothesize that the use of molecular markers as an adjunct to FNA cytology can improve the distinction of benign from malignant nodules that have associated suspicious or indeterminate cytology. METHODS Using microarray analysis, we previously identified and reported on 75 genes useful in the distinction of benign versus malignant thyroid nodules. In the present study, we have further validated the expression of 14 of these markers in a large number of thyroid samples by immunohistochemistry (IHC) analysis of 154 thyroid tumors and quantitative real-time RT-PCR (QRT-PCR) analysis of 95 FNA samples. Of the 154 tumors analyzed by IHC, 44 samples (29%) had associated suspicious or indeterminate FNA cytology. RESULTS Receiver operating characteristic using three-gene model, (HMGA2, MRC2, and SFN) analysis for the detection of malignant nodules resulted in areas under the curve (AUCs) of≥0.95 (80% sensitivity; 100% specificity) and≥0.84 (71% sensitivity; 84% specificity) for the IHC data in tumors, and QRT-PCR data in FNA samples, respectively. CONCLUSIONS Our results suggest that a three-gene model for the cytological diagnosis of indeterminate thyroid nodules is both feasible and promising. Implementation of this as an adjunct to thyroid cytology may significantly impact the clinical management of patients with suspicious or indeterminate thyroid FNA nodules.
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Affiliation(s)
- Nijaguna B. Prasad
- Endocrine Surgery Section, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jeanne Kowalski
- Division of Oncology Biostatistics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Hua-Ling Tsai
- Division of Oncology Biostatistics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kristin Talbot
- Endocrine Surgery Section, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Helina Somervell
- Endocrine Surgery Section, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Guennadi Kouniavsky
- Endocrine Surgery Section, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Yongchun Wang
- Endocrine Surgery Section, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alan P.B. Dackiw
- Endocrine Surgery Section, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - William H. Westra
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Douglas P. Clark
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Steven K. Libutti
- Department of Surgery, Albert Einstein College of Medicine, New York, New York
| | - Christopher B. Umbricht
- Endocrine Surgery Section, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Martha A. Zeiger
- Endocrine Surgery Section, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
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20
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PAUNOVIC IVAN, ISIC TIJANA, HAVELKA MARIJA, TATIC SVETISLAV, CVEJIC DUBRAVKA, SAVIN SVETLANA. Combined immunohistochemistry for thyroid peroxidase, galectin-3, CK19 and HBME-1 in differential diagnosis of thyroid tumors. APMIS 2011; 120:368-79. [DOI: 10.1111/j.1600-0463.2011.02842.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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21
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Bauer AJ, Francis GL. Update on the molecular signature of differentiated thyroid cancer: clinical implications and potential opportunities. Expert Rev Endocrinol Metab 2011; 6:819-834. [PMID: 30780870 DOI: 10.1586/eem.11.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
With the development and maturation of new technologies, there has been a steady incorporation of powerful new tools into the evaluation and management of thyroid nodules and thyroid cancer. An increasing number of reports on oncogene testing and molecular screening in fine-needle aspiration biopsy samples have been published. However, there remains a paucity of data and consensus on combining both conventional and molecular technologies to determine the diagnosis and/or prognosis of disease. All patients with differentiated thyroid cancer stand to benefit from the identification and incorporation of reliable molecular markers into clinical practice. Identification of reliable markers would allow for stratification of treatment, affording the medical and surgical teams an ability to individually tailor evaluation and treatment, applying aggressive therapy and monitoring only when clinically warranted. For the majority of patients with thyroid cancer, the incorporation of a validated, multifaceted molecular profiling system may not improve survival; however, there is great opportunity for these efforts to decrease the morbidity associated with our current approach.
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Affiliation(s)
- Andrew J Bauer
- a Pediatric Endocrinology, Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC, USA.
- b Uniformed Services University, Bethesda, MD, USA
- c Thyroid Center, Division of Endocrinology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Gary L Francis
- d Division of Endocrinology, Department of Pediatrics, Children's Hospital of Richmond at The Commonwealth University Health System, Medical College of Virginia, Richmond, VA, USA
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Wémeau JL, Sadoul JL, d'Herbomez M, Monpeyssen H, Tramalloni J, Leteurtre E, Borson-Chazot F, Caron P, Carnaille B, Léger J, Do C, Klein M, Raingeard I, Desailloud R, Leenhardt L. Guidelines of the French society of endocrinology for the management of thyroid nodules. ANNALES D'ENDOCRINOLOGIE 2011; 72:251-281. [PMID: 21782154 DOI: 10.1016/j.ando.2011.05.003] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2011] [Accepted: 05/13/2011] [Indexed: 01/21/2023]
Abstract
The present document is a follow-up of the clinical practice guidelines of the French Society of Endocrinology, which were established for the use of its members and made available to scientific communities and physicians. Based on a critical analysis of data from the literature, consensuses and guidelines that have already been published internationally, it constitutes an update of the report on the diagnostic management of thyroid nodules that was proposed in France, in 1995, under the auspices of the French National Agency for Medical Evaluation (l'Agence nationale d'évaluation médicale). The current guidelines were deliberated beforehand by a number of physicians that are recognised for their expertise on the subject, coming from the specialities of endocrinology (the French Thyroid Research Group) and surgery (the French Association for Endocrine Surgery), as well as representatives from the fields of biology, ultrasonography, cytology and nuclear medicine. The guidelines were presented and submitted for the opinion of the members of the Society at its annual conference, which was held in Nice from 7-10 October 2009. The amended document was posted on the website of the Society and benefited from additional remarks of its members. The final version that is presented here was not subjected to methodological validation. It does not claim to be universal in its scope and will need to be revised in concert with progress made in technical and developmental concepts. It constitutes a document that the Society deems useful for distribution concerning the management of thyroid nodules, which is current, efficient and cost effective.
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Affiliation(s)
- J-L Wémeau
- Hôpital Claude-Huriez, clinique endocrinologique, CHRU, 59037 Lille cedex, France.
| | - J-L Sadoul
- Endocrinologie, hôpital de l'Archet, CHU 06202 Nice cedex, France
| | - M d'Herbomez
- Département de médecine nucléaire, centre de biologie pathologie, centre hospitalier régional, 59037 Lille cedex, France
| | - H Monpeyssen
- Centre de radiologie, imagerie médicale et échographie thyroïdienne, hôpital Necker, 141, rue de Sèvres, 75015 Paris, France
| | - J Tramalloni
- Centre de radiologie, imagerie médicale et échographie thyroïdienne, hôpital Necker, 141, rue de Sèvres, 75015 Paris, France
| | - E Leteurtre
- Inserm U560, service d'anatomie pathologique, CHRU de Lille, Lille, France
| | - F Borson-Chazot
- Hôpital Louis-Pradel, CHU des hospices civils de Lyon, 28, avenue Doyen-Lépine, 69500 Bron, France
| | - P Caron
- CHU Larrey, avenue du Jean-Poulhès, 31400 Toulouse, France
| | - B Carnaille
- Hôpital Claude-Huriez, clinique endocrinologique, CHRU, 59037 Lille cedex, France
| | - J Léger
- Service d'endocrinologie et diabétologie pédiatriques, hôpital Robert-Debré, 48, boulevard Sérurier, 75935 Paris cedex 19, France
| | - C Do
- Hôpital Claude-Huriez, clinique endocrinologique, CHRU, 59037 Lille cedex, France
| | - M Klein
- Service d'endocrinologie, CHU de Nancy, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France
| | - I Raingeard
- Service des maladies métaboliques et endrocriennes, hôpital Lapeyronie, 34295 Montpellier cedex 5, France
| | - R Desailloud
- Service d'endocrinologie, diabétologie et nutrition, hôpital Sud, CHU d'Amiens, avenue René-Laënnec, 80054 Amiens, France
| | - L Leenhardt
- Service de médecine nucléaire, hôpital Pitié-Salpêtrière, université Paris VI, 47-83, boulevard de l'Hôpital, 75651 Paris cedex 13, France
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Ducena K, Abols A, Vilmanis J, Narbuts Z, Tārs J, Andrējeva D, Linē A, Pīrāgs V. Validity of multiplex biomarker model of 6 genes for the differential diagnosis of thyroid nodules. Thyroid Res 2011; 4:11. [PMID: 21707985 PMCID: PMC3155827 DOI: 10.1186/1756-6614-4-11] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Accepted: 06/27/2011] [Indexed: 11/10/2022] Open
Abstract
Background Currently the cytological examination of fine needle aspiration (FNA) biopsies is the standard technique for the pre-operative differential diagnosis of thyroid nodules. However, the results may be non-informative in ~20% of cases due to an inadequate sampling and the lack of highly specific, measurable cytological criteria, therefore ancillary biomarkers that could aid in these cases are clearly needed. The aim of our study was to evaluate the mRNA expression levels of 8 candidate marker genes as the diagnostic biomarkers for the discrimination of benign and malignant thyroid nodules and to find a combination of biomarkers with the highest diagnostic value. Materials and methods mRNA expression levels of eight candidate marker genes - BIRC5, CCND1, CDH1, CITED1, DPP4, LGALS3, MET and TFF3 was measured by real-time RT-PCR in paired nodular and surrounding normal thyroid tissue specimens of 105 consecutive patients undergoing thyroid surgery and compared between different types of thyroid lesions. Results Significant differences in the mRNA expression levels between the normal and malignant thyroid tissues and between benign and malignant nodules were found for BIRC5, CCND1, CITED1, DPP4, LGALS3, MET and TFF3, but not CDH1. On a single gene basis, relative quantity (RQ) of LGALS3 had the highest diagnostic value for the discrimination of malignant and benign thyroid nodules (AUC = 0.832, P < 0.0001 and 90.9% sensitivity and 65.6% specificity at the optimal cut-off on ROC curve). The only two-marker set that outperformed LGALS3 was RQ sum of LGALS3 and BIRC5 (AUC = 0.841, P < 0.0001). An application of multivariate logistic regression analysis resulted in the generation of a multiplex biomarker model based on LGALS3, BIRC5, TFF3, CCND1, MET and CITED1 that had considerably higher specificity than a single marker or two marker gene-based models (AUC = 0.895, P < 0.0001, 70.5% sensitivity and 93.4% specificity). Conclusions This study confirmed that mRNA expression levels of 7 out of 8 candidate genes analysed have a diagnostic value for the distinction of benign and malignant thyroid nodules. The multiplex biomarker model based on 6 genes outperformed a single marker or two marker-based models and warrants feasibility studies on FNA biopsies and the validation in a larger cohort of patients.
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Affiliation(s)
- Kristine Ducena
- Faculty of Medicine, University of Latvia, Raina Bulvaris 19, Riga, LV1586, Latvia.
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Diagnostic utility of immunohistochemical panel in various thyroid pathologies. Langenbecks Arch Surg 2010; 395:885-91. [PMID: 20640858 DOI: 10.1007/s00423-010-0690-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 07/05/2010] [Indexed: 01/16/2023]
Abstract
BACKGROUND For management of thyroid nodules, distinction between benign and malignant tumours is essential. The study was performed to evaluate the diagnostic value of molecular markers in different thyroid tumours. MATERIALS AND METHODS Immunohistochemistry for CD56, HBME-1, COX-2, Ki-67, p53 and E-cadherin (E-CAD) was performed in 113 benign and 35 malignant thyroid lesions including 36 follicular adenomas (FA), 77 colloid goitres, 26 papillary thyroid carcinomas (PTC) and 9 follicular carcinomas (FC). The results were scored semiquantitatively by staining intensity (0-3 scale) and percentage of positive cells. RESULTS PTC was characterised by decreased E-CAD and CD56 expression in contrast to surrounding benign thyroid tissues. HBME-1 expression was absent in benign thyroid tissues but was notably high in PTC and occasionally in FC. The expression of E-CAD and CD56 in FA was significantly higher than in the surrounding thyroid tissues. No expression of p53 was found in any group. The expression of COX-2 was low in all lesions. The proliferation activity by Ki-67 was generally low; however, it was significantly higher in cancers. CONCLUSIONS The panel consisting of three markers, HBME-1, E-CAD and CD56, can be recommended as an adjunct to morphology criteria. HBME-1 is found in malignant lesions only and is the most sensitive and specific single marker in PTC. Decreased expression of E-CAD and CD56 distinguishes PTC from FA and FC. Both FA and FC are characterised by high expression of E-CAD and CD56. The practical use of Ki-67 is difficult due to low values. The role of adhesion factors in thyroid malignancies may be superior in comparison with cell proliferation.
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Thyroid fine needle aspiration biopsies in children: study of cytological-histological correlation and immunostaining with thyroid peroxidase monoclonal antibodies. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2010; 2010:690108. [PMID: 20652042 PMCID: PMC2905910 DOI: 10.1155/2010/690108] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 02/19/2010] [Accepted: 04/30/2010] [Indexed: 01/21/2023]
Abstract
Context. There is limited data comparing results of fine needle aspiration biopsies (FNABs) to histological diagnosis in children.
Design. FNABs were performed in 707 children and cytological results were compared to histology in 165 cases. The usefulness of immunostaining with anti-TPO monoclonal antibodies (MoAb47) on FNAB samples was examined in 54 operated patients.
Results. Among unsatisfactory, benign, suspicious, and malignant FNAB, the histological diagnoses were benign in 12/12 (100%), 69/70 (98.5%), 40/50 (80.0%), and 0/33 (0%), respectively. After surgery, malignancy was established in 44/165 (26.6%) cases. The sensitivity, specificity, and positive and negative predictive values were 95.4%, 55.8%, 61.7%, and 95% with standard FNAB; and 100%, 75%, 73.3, and 100% with MoAb47. Among suspicious FNAB, positive MoAb47 staining was a reliable marker for exclusion of malignancy.
Conclusion. Benign and malignant FNAB accurately predict histological diagnosis. In suspicious FNAB, MoAb47 immunostaining may be a useful adjunct to standard cytology.
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Hoperia V, Larin A, Jensen K, Bauer A, Vasko V. Thyroid Fine Needle Aspiration Biopsies in Children: Study of Cytological-Histological Correlation and Immunostaining with Thyroid Peroxidase Monoclonal Antibodies. INTERNATIONAL JOURNAL OF PEDIATRIC ENDOCRINOLOGY 2010. [DOI: 10.1186/1687-9856-2010-690108] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Abstract
Although fine-needle aspiration biopsy (FNA) remains the mainstay of the preoperative workup of thyroid nodules, it does not provide a diagnosis in up to 20% of nodules. This group of indeterminate lesions, including lesions with cellular atypia, suspicious cytology, and demonstrating a follicular pattern, provides one of the greatest challenges to researchers in thyroid cancer today. Over the last 2 decades, considerable work has been done to find molecular markers to resolve this diagnostic dilemma. This article explores some of the markers including galectin-3, HBME-1, BRAF, RET/PTC, PAX8-PPARgamma, hTERT, telomerase, miRNA, and microarray and multigene assays. Although no one marker has proven to be a panacea, several combinations of markers have shown great promise as an adjunct to FNA.
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Affiliation(s)
- Meredith A Kato
- Division of Endocrine Surgery, Department of Surgery, New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY 10068, USA.
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Cordero OJ, Salgado FJ, Nogueira M. On the origin of serum CD26 and its altered concentration in cancer patients. Cancer Immunol Immunother 2009; 58:1723-47. [PMID: 19557413 PMCID: PMC11031058 DOI: 10.1007/s00262-009-0728-1] [Citation(s) in RCA: 156] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2009] [Accepted: 06/02/2009] [Indexed: 12/23/2022]
Abstract
Dipeptidyl peptidase IV (DPP-IV), assigned to the CD26 cluster, is expressed on epithelial cells and lymphocytes and is a multifunctional or pleiotropic protein. Its peptidase activity causes degradation of many biologically active peptides, e.g. some incretins secreted by the enteroendocrine system. DPP-IV has, therefore, become a novel therapeutic target for inhibitors that extend endogenously produced insulin half-life in diabetics, and several reviews have appeared in recent months concerning the clinical significance of CD26/DPP-IV. Biological fluids contain relatively high levels of soluble CD26 (sCD26). The physiological role of sCD26 and its relation, if any, to CD26 functions, remain poorly understood because whether the process for CD26 secretion and/or shedding from cell membranes is regulated or not is not known. Liver epithelium and lymphocytes are often cited as the most likely source of sCD26. It is important to establish which tissue or organ is the protein source as well as the circumstances that can provoke an abnormal presence/absence or altered levels in many diseases including cancer, so that sCD26 can be validated as a clinical marker or a therapeutic target. For example, we have previously reported low levels of sCD26 in the blood of colorectal cancer patients, which indicated the potential usefulness of the protein as a biomarker for this cancer in early diagnosis, monitoring and prognosis. Through this review, we envisage a role for sCD26 and the alteration of normal peptidase capacity (in clipping enteroendocrine or other peptides) in the complex crosstalk between the lymphoid lineage and, at least, some malignant tumours.
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Affiliation(s)
- Oscar J Cordero
- Department of Biochemistry and Molecular Biology, CIBUS, University of Santiago de Compostela, r/Lopez de Marzoa s/n, Campus Sur, 15782 Santiago de Compostela, Spain.
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Arcinas A, Yen TY, Kebebew E, Macher BA. Cell surface and secreted protein profiles of human thyroid cancer cell lines reveal distinct glycoprotein patterns. J Proteome Res 2009; 8:3958-68. [PMID: 19530676 DOI: 10.1021/pr900278c] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Cell surface proteins have been shown to be effective therapeutic targets. In addition, shed forms of these proteins and secreted proteins can serve as biomarkers for diseases, including cancer. Thus, identification of cell surface and secreted proteins has been a prime area of interest in the proteomics field. Most cell surface and secreted proteins are known to be glycosylated, and therefore, a proteomics strategy targeting these proteins was applied to obtain proteomic profiles from various thyroid cancer cell lines that represent the range of thyroid cancers of follicular cell origin. In this study, we oxidized the carbohydrates of secreted proteins and those on the cell surface with periodate and isolated them via covalent coupling to hydrazide resin. The glycoproteins obtained were identified from tryptic peptides and N-linked glycopeptides released from the hydrazide resin using two-dimensional liquid chromatography-tandem mass spectrometry in combination with the gas phase fractionation. Thyroid cancer cell lines derived from papillary thyroid cancer (TPC-1), follicular thyroid cancer (FTC-133), Hurthle cell carcinoma (XTC-1), and anaplastic thyroid cancer (ARO and DRO-1) were evaluated. An average of 150 glycoproteins were identified per cell line, of which more than 57% are known cell surface or secreted glycoproteins. The usefulness of the approach for identifying thyroid cancer associated biomarkers was validated by the identification of glycoproteins (e.g., CD44, galectin 3 and metalloproteinase inhibitor 1) that have been found to be useful markers for thyroid cancer. In addition to glycoproteins that are commonly expressed by all of the cell lines, we identified others that are only expressed in the more well-differentiated thyroid cancer cell lines (follicular, Hurthle cell and papillary), or by cell lines derived from undifferentiated tumors that are uniformly fatal forms of thyroid cancer (i.e., anaplastic). On the basis of the results obtained, a set of glycoprotein biomarker candidates for thyroid cancer is proposed.
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Affiliation(s)
- Arthur Arcinas
- Department of Chemistry and Biochemistry, San Francisco State University, California 94132, USA
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30
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De Meester I, Scharpé S, Lambeir AM. Dipeptidyl peptidases and related proteins: multifaceted markers and therapeutic targets. Clin Chem Lab Med 2009; 47:245-7. [DOI: 10.1515/cclm.2009.085] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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31
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Griffith OL, Chiu CG, Gown AM, Jones SJM, Wiseman SM. Biomarker panel diagnosis of thyroid cancer: a critical review. Expert Rev Anticancer Ther 2008; 8:1399-413. [PMID: 18759692 DOI: 10.1586/14737140.8.9.1399] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The accurate preoperative diagnosis of thyroid cancer continues to be a significant challenge for those individuals who present with nodular thyroid disease, particularly for tumors with indeterminate cytomorphological features by fine-needle aspiration biopsy. In an effort to develop improved diagnostic tools, a number of studies have investigated the discriminatory potential of many different RNA and protein molecules. However, no individual thyroid cancer biomarker has been found with sufficient sensitivity and specificity. Therefore, research focus has shifted to panels of multiple markers with the hope of improved performance and robustness. A panel comprised of GAL3, CK19 and HBME1 is by far the most studied to date and offers some improvement over individual marker performance alone. However, relatively few marker panels have been studied and their performances and application as diagnostic tests have not been consistently reported. We present a comprehensive review of molecular marker panel studies for thyroid tumors and current issues and challenges. In the future, studies evaluating larger numbers of biomarkers in large patient cohorts are required for the development and validation of a clinically applicable test.
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Affiliation(s)
- Obi L Griffith
- Department of Medical Genetics, University of British Columbia & Michael Smith Genome, Sciences Center, British Columbia Cancer Research Centre, 100-570 West 7th Avenue, Vancouver, BC V5Z 4S6, Canada.
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32
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Wiseman SM, Melck A, Masoudi H, Ghaidi F, Goldstein L, Gown A, Jones SJM, Griffith OL. Molecular phenotyping of thyroid tumors identifies a marker panel for differentiated thyroid cancer diagnosis. Ann Surg Oncol 2008; 15:2811-26. [PMID: 18612701 DOI: 10.1245/s10434-008-0034-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2008] [Revised: 06/03/2008] [Accepted: 06/04/2008] [Indexed: 01/09/2023]
Abstract
BACKGROUND Currently, a large proportion of individuals undergo thyroidectomy as a diagnostic procedure for cancer. The objective of this work was to evaluate the molecular phenotype of differentiated thyroid cancer (DTC) and benign thyroid lesions to identify molecular markers that allow for accurate thyroid cancer diagnosis. METHODS Tissue microarrays consisting of 100 benign and 105 malignant thyroid lesions, plus 24 lymph node samples, were stained for a panel of 57 molecular markers. Significant associations between marker staining and tumor pathology (DTC versus benign) were determined using contingency table and Mann-Whitney U (MU) tests. A Random Forests classifier algorithm was also used to identify useful/important molecular classifiers. RESULTS Of the 57 diagnostic markers evaluated 35 (61%) were significantly associated with a DTC diagnosis after multiple testing correction. Of these, in DTC compared with benign thyroid tumors, 8 markers were downregulated and 27 upregulated. The most significant markers for DTC diagnosis were: Galectin-3, Cytokeratin 19, Vascular Endothelial Growth Factor, Androgen Receptor, p16, Aurora-A, and HBME-1. Using the entire molecular marker panel, a Random Forests algorithm was able to classify tumors as DTC or benign with an estimated sensitivity of 87.9%, specificity of 94.0%, and an accuracy of 91.0%. CONCLUSION Evaluation of the DTC and benign thyroid tumor molecular phenotype has allowed for identification of a marker panel, composed of both established and novel markers, useful for thyroid cancer diagnosis. These results suggest that further study of the molecular profile of thyroid tumors is warranted, and a diagnostic molecular marker panel may potentially improve patient selection for thyroid surgery.
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Affiliation(s)
- Sam M Wiseman
- Department of Surgery, St. Paul's Hospital, University of British Columbia, C303-1081 Burrard Street, Vancouver, BC, Canada.
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Šedo A, Stremenová J, Bušek P, Duke-Cohan JS. Dipeptidyl peptidase-IV and related molecules: markers of malignancy? ACTA ACUST UNITED AC 2008; 2:677-89. [DOI: 10.1517/17530059.2.6.677] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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