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Peștean C, Pavel A, Piciu D. Clinical and Paraclinical Considerations Regarding ki67's Role in the Management of Differentiated Thyroid Carcinoma-A Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:769. [PMID: 38792952 PMCID: PMC11123096 DOI: 10.3390/medicina60050769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 04/29/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
Background and Objectives: The ki67 nuclear protein is a tool for diagnosis and prognosis in oncology that is used to evaluate cell proliferation. Differentiated thyroid carcinoma is usually a slow-growing neoplasm, the most common type being the papillary form. Some clinical and pathological aspects may predict aggressive behaviour. There are reported cases of recurrence without clinico-pathological findings of aggressiveness. To obtain better predictions of the disease outcome in thyroid carcinoma, many immunohistochemical markers have been studied. The aim of this narrative literature review is to identify the benefits that ki67 may add to the management of patients with differentiated thyroid carcinoma, according to the latest evidence. Materials and Methods: We performed a search on the PubMed and Google Scholar databases using controlled vocabulary and keywords to find the most suitable published articles. A total number of sixty-eight items were identified, and five other articles were selected from other sources. After refining the selection, the inclusion criteria and exclusion criteria were applied, and a total number of twenty-nine articles were included in this literature review. Results and Discussion: The studies consist of retrospective studies (89.66%), case reports (6.9%) and literature reviews (3.45%), evaluating the role, implications and other parameters of ki67 as a diagnostic and/or prognostic tool. The statistical correlations between ki67 and other features were systematized as qualitative results of this review in order to improve the treatment strategies presented in the included articles. Conclusions: The included studies present converging data regarding most of the aspects concerning ki67. The ki67 proliferation index is a diagnostic/prognostic tool of interest in differentiated thyroid carcinoma and a good predictor of disease-free survival, disease recurrence and metastatic development. Prospective studies on large cohorts may add value for ki67 as a specific tool in the management strategy of differentiated thyroid carcinoma.
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Affiliation(s)
- Claudiu Peștean
- Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Prof. Dr. Ion Chiricuță Institute of Oncology, Department of Nuclear Medicine, 400015 Cluj-Napoca, Romania
- Affidea CT Clinic, 400015 Cluj-Napoca, Romania
| | - Alexandru Pavel
- Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Affidea CT Clinic, 400015 Cluj-Napoca, Romania
- Emergency Clinical County Hospital, 400347 Cluj-Napoca, Romania
| | - Doina Piciu
- Faculty of Medicine, Iuliu Hațieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania
- Affidea CT Clinic, 400015 Cluj-Napoca, Romania
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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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Sengun S, Korkmaz H, Ciris M, Yüceer RO, Boyluboy SM, Kiran M. Diagnostic and prognostic value of Stanniocalcin 1 expression in papillary thyroid cancer. Endocrine 2022; 78:95-103. [PMID: 35788886 DOI: 10.1007/s12020-022-03126-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/22/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To evaluate the potential role of immunohistochemical changes in stanniocalcin 1 (STC1) and stanniocalcin 2 (STC2) expressions in papillary thyroid cancer (PTC) tissues in the disease's diagnosis and to investigate their relationship with classical clinicopathological prognostic factors. METHODS The study included 100 patients with PTC. Normal thyroid tissue adjacent to the tumor was taken as the control group. Clinicopathological prognostic features at the time of diagnosis of patients were recorded. STC1 and STC2 expressions of tumor tissue and adjacent normal tissue were determined immunohistochemically. RESULTS The sensitivity of STC1 in the diagnosis of PTC was 93%, the specificity was 94%, positive predictive value (PPV) 93.9%, and negative predictive value (NPV) 93.1%. It was determined that the STC1 staining score in tumor tissue was positively correlated with the disease TNM stage score (r = 0.259, p = 0.009) and the increase in STC1 staining score were independent risk factors that increased the risk of lymph node metastasis (R2 = 0.398, p < 0.001). While 21% of the tumor tissues were stained with STC2, none of the normal thyroid tissues adjacent to the tumor tissue showed any staining with STC2. No correlation was found between STC2 immunohistochemical staining of tumor tissue and clinicopathological risk factors for the disease. CONCLUSION Increased STC1 expression in thyroid lesions may be helpful in diagnosing PTC. In addition, since increased STC1 expression in PTC tissues is associated with the risk of lymph node metastasis, it may be an efficient marker for predicting the prognosis of the disease.
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Affiliation(s)
- Sevinç Sengun
- Department of Internal Medicine, Faculty of Medicine, Suleyman Demirel University, 32260, Cunur, Isparta, Turkey
| | - Hakan Korkmaz
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, Suleyman Demirel University, 32260, Cunur, Isparta, Turkey.
| | - Metin Ciris
- Department of Pathology, Faculty of Medicine, Suleyman Demirel University, 32260, Cunur, Isparta, Turkey
| | - Ramazan Oguz Yüceer
- Department of Pathology, Faculty of Medicine, Suleyman Demirel University, 32260, Cunur, Isparta, Turkey
| | - Serife Mehtap Boyluboy
- Department of Internal Medicine, Division of Endocrinology, Faculty of Medicine, Suleyman Demirel University, 32260, Cunur, Isparta, Turkey
| | - Mehmet Kiran
- Department of Pathology, Faculty of Medicine, Suleyman Demirel University, 32260, Cunur, Isparta, Turkey
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The Utility of Galectin-3 and HBME-1 Immunohistochemical Expression in Thyroid Cancer in the Maltese Population. ENDOCRINES 2022. [DOI: 10.3390/endocrines3020021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Diagnosing thyroid carcinoma is not always easy on basic haemtoxylin and eosin staining since nuclear features are inconsistent and controversial. In view of this, studies on the role of immunohistochemical markers in the diagnosis of malignant thyroid carcinoma are necessary. Proposed immunohistochemical markers for papillary thyroid cancer include Hector Battifora mesothelial-1 (HBME-1), and Galectin-3 (Gal-3) which have been studied in this project. Immunohistochemical staining of fifty-eight formalin-fixed paraffin embedded surgically removed thyroid tissue from the years 2008 and 2013 was undertaken to determine the diagnostic accuracy of these two markers. We have concluded that both Gal-3 and HBME-1 are useful markers to aid in the diagnosis of papillary thyroid carcinoma and also in distinguishing between benign and malignant thyroid lesions. The sensitivity and specificity of Gal-3 over the 2years studied was found to be 96.2% and 92.6%, respectively, whilst HBME-1 was found to have sensitivity of 93.6% and specificity of 69.02%.
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Prasad PA, Raju K. Diagnostic utility of CK19 and galectin-3 in differentiating papillary thyroid carcinoma from nonneoplastic lesions of thyroid. J Cancer Res Ther 2022; 18:644-649. [PMID: 35900535 DOI: 10.4103/jcrt.jcrt_563_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Thyroid neoplasm is one of the most common endocrine neoplasms. The diagnosis and the distinction between malignant and benign neoplasms can be difficult, but it has clinical, therapeutic, and prognostic significance. Hence, it is necessary to make precise diagnosis by using biomarkers. Materials and Methods This is a laboratory observational study considering histologically diagnosed cases of papillary thyroid carcinoma (PTC) and nonneoplastic thyroid lesions. Immunohistochemistry (IHC) staining was done on tissue sections of all cases for CK19 and galectin-3 using appropriate positive and negative controls. The expression of immunomarkers was evaluated by a semi-quantitative method as negative, weak positive, moderate positive, and strong positive. The data were entered in Microsoft Excel sheet and were analyzed using SPSS 22 version software. Results A total of 52 cases were considered for the study, of which 26 cases each were PTC and nonneoplastic lesions of thyroid. Among the 26 PTC cases, 6 were classical variant of PTC (CVPTC) and 20 were follicular variant of papillary thyroid carcinoma (FVPTC). Among 26 nonneoplastic cases, 13 each were nodular hyperplasia cases and lymphocytic thyroiditis. There was a statistically significant (P < 0.01) association of CK19 and galectin-3 expression between CVPTC and FVPTC. There was no statistically significant association (P = 0.271) of CK19 expression between PTC and nonneoplastic cases. There was a statistically significant association (P = 0.003) of galectin-3 expression between PTC and nonneoplastic cases. Conclusion Galectin-3 expression can be used to differentiate PTC from nonneoplastic lesions of thyroid in ambiguous cases. Galectin-3 and CK19 expression can be used to classify PTC into CVPTC and FVPTC.
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Affiliation(s)
- Priyanka Arvind Prasad
- Department of Pathology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
| | - Kalyani Raju
- Department of Pathology, Sri Devaraj Urs Medical College, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, Karnataka, India
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Ramkumar S, Sivanandham S. The Combined Utility of HBME-1 and Galectin-3 Immunohistochemistry and BRAF V600E Mutations in the Diagnosis of Papillary Thyroid Carcinoma. Cureus 2021; 13:e20339. [PMID: 34934597 PMCID: PMC8668044 DOI: 10.7759/cureus.20339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2021] [Indexed: 12/03/2022] Open
Abstract
Newer diagnostic modalities have revolutionized the pathologist’s approach to diagnosing thyroid malignancies. Molecular characterization of these malignancies has helped circumvent common morphologic diagnostic difficulties by integrating their genotypic, phenotypic, and immunohistochemical features. BRAF V600E mutation has been characterized as highly specific for thyroid carcinoma, especially papillary thyroid carcinoma (PTC); human bone marrow endothelial marker-1 (HBME-1) and galectin-3 are also such markers that are highly specific for PTC. We propose to study HBME-1 and galectin-3 expression and BRAF V600E mutation in thyroid neoplasms and do a comparative analysis to determine whether there is a correlation between BRAF V600E expression and that of HBME-1 and galectin-3. We further propose to analyze the individual and combined diagnosed utility of the above-mentioned ancillary diagnostic techniques.
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Menz A, Bauer R, Kluth M, Marie von Bargen C, Gorbokon N, Viehweger F, Lennartz M, Völkl C, Fraune C, Uhlig R, Hube-Magg C, De Wispelaere N, Minner S, Sauter G, Kind S, Simon R, Burandt E, Clauditz T, Lebok P, Jacobsen F, Steurer S, Wilczak W, Krech T, Marx AH, Bernreuther C. Diagnostic and prognostic impact of cytokeratin 19 expression analysis in human tumors: a tissue microarray study of 13,172 tumors. Hum Pathol 2021; 115:19-36. [PMID: 34102222 DOI: 10.1016/j.humpath.2021.05.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/27/2021] [Indexed: 12/13/2022]
Abstract
To evaluate cytokeratin 19 (CK19) expression in normal and cancerous tissues, 15,977 samples from 122 tumor types and 608 samples of 76 normal tissue types were analyzed by immunohistochemistry (IHC). In normal tissues, CK19 expression occurred in epithelial cells of most glandular organs but was strictly limited to the basal cell layer of nonkeratinizing squamous epithelium and absent in the skin. CK19 expression in ≥90% of cases was seen in 34% of the tumor entities including the adenocarcinomas of the pancreas (99.4%), colorectum (99.8%), esophagus (98.7%), and stomach (97.7%), as well as breast cancer (90.0%-100%), high-grade serous (99.1%) or endometrioid (97.8%) ovarian cancer, and urothelial carcinoma (92.6%-100%). A low CK19 positivity rate (0.1-10%) was seen in 5 of 122 tumor entities including hepatocellular carcinoma and seminoma. A comparison of tumor versus normal tissue findings demonstrated that upregulation and downregulation of CK19 can occur in cancer and that both alterations can be linked to unfavorable phenotypes. CK19 downregulation was linked to high grade (p = 0.0017) and loss of estrogen receptor- and progesterone receptor-expression (p < 0.0001 each) in invasive breast carcinoma of no special type. CK19 upregulation was linked to nodal metastases in neuroendocrine tumors and papillary thyroid carcinomas (p < 0.05 each) and to poor grade in clear cell renal cell carcinoma (p < 0.05). CK19 upregulation was particularly common in squamous cell carcinomas. We concluded that CK19 IHC might separate primary liver cell carcinoma from liver metastases, seminoma from other testicular tumors, and helps in the detection of early neoplastic transformation in squamous epithelium.
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Affiliation(s)
- Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Rifka Bauer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Clara Marie von Bargen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Florian Viehweger
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Cosima Völkl
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Ria Uhlig
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Noémi De Wispelaere
- Department and Clinic of Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Simon Kind
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany.
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Till Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Till Krech
- Institute of Pathology, Clinical Center Osnabrueck, 49076 Osnabrueck, Germany
| | - Andreas H Marx
- Department of Pathology, Academic Hospital Fuerth, 90766 Fuerth Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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Viana ADOR, Gonçalves Filho J, Francisco ALN, Pinto CAL, Kowalski LP. Ki-67 and CK-19 are predictors of locoregional recurrence in papillary thyroid carcinoma. ACTA ACUST UNITED AC 2021; 40:190-197. [PMID: 32773780 PMCID: PMC7416367 DOI: 10.14639/0392-100x-n0311] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 01/09/2020] [Indexed: 12/27/2022]
Abstract
Most patients with papillary thyroid carcinoma have good prognosis; however, recurrence rates and the need of salvage treatment remain a significant problem for 5-40% of patients. Although several risk classifications based on clinicopathological prognostic factors are used, it is not possible to predict which patients will have a higher risk of recurrence. The objective of the study is to analyse the impact of cytokeratin-19 and Ki-67 immunoexpression as predictive markers of the risk of recurrence in papillary thyroid carcinoma. This is a retrospective case-control study, including 42 patients with papillary thyroid carcinoma and 42 controls. The groups were matched by gender, age and pathological staging T and N. Slides were made by the microarray tissue system. Multivariate logistic regression was applied to identify an independent risk factor for recurrence. Of the 42 selected cases, 30 patients (71.4%) were female and 12 (28.6%) were male, ranging in age from 10 to 80 years (median of 39 years). Most patients (64.3%) had tumors at initial T staging (T1-T2). Half of the sample was classified as low risk according to the American Thyroid Association (ATA) risk stratification. Follow-up time ranged from 46 to 196 months, with time to recurrence from 2 to 106 months (median, 30 months). CK-19 and Ki-67 immunoexpression had a statistically significant association with the risk of recurrence (p = 0.029 and p = 0.007, respectively). In multivariate logistic regression analysis, immunoexpression for these markers was an independent risk factor for locoregional recurrence (OR-9,64; CI-1.14-81.01 and OR-3,21; CI-1.32-7.94, respectively). The immunohistochemical analysis of the Ki-67 and CK-19 markers is useful to predict tumour recurrence in patients with papillary thyroid carcinoma.
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Affiliation(s)
- Aline de Oliveira Ribeiro Viana
- Department of Head and Neck Surgery and Otorhinolaryngology, Heliopolis Hospital, São Paulo, Brazil.,Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - João Gonçalves Filho
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | | | | | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil.,Department of Head and Neck Surgery, University of Sao Paulo Medical School, São Paulo, Brazil
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Diagnostic Value of TROP2 Expression in Papillary Thyroid Carcinoma. Appl Immunohistochem Mol Morphol 2020; 29:218-222. [PMID: 33264108 DOI: 10.1097/pai.0000000000000886] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/14/2020] [Indexed: 01/22/2023]
Abstract
Papillary thyroid carcinoma (PTC) represents the most common primary malignant thyroid lesion in all age groups. As diagnosis of PTC could be challenging in some cases and borderline nuclear features could be seen in some benign mimickers, several immunohistochemical markers are proposed to be helpful for making the correct diagnosis. In this study the authors investigated the diagnostic value of transmembrane glycoprotein (TROP2) for differentiating PTC from other thyroid follicular lesions. A total of 155 total thyroidectomy specimens including 84 cases of PTC and 71 cases of non-PTC were investigated. Among non-PTC group, 45 cases were follicular neoplasms and 26 cases were Hashimoto thyroiditis. TROP2 expression was observed in 82 of 84 cases of PTC group. In contrast only 5 cases of non-PTC group, all from Hashimoto thyroiditis specimens, showed positive expression. The sensitivity, specificity, positive predictive value, and negative predictive value of TROP2 for diagnosis of PTC was 98%, 93%, 94%, and 97%, respectively. The authors concluded that high sensitivity and specificity of TROP2 as well as its uniform negative reaction in follicular adenoma and carcinoma makes it a valuable immunohistochemical marker for diagnosis of PTC.
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Guadagno E, D'Avella E, Cappabianca P, Colao A, Del Basso De Caro M. Ki67 in endocrine neoplasms: to count or not to count, this is the question! A systematic review from the English language literature. J Endocrinol Invest 2020; 43:1429-1445. [PMID: 32415572 DOI: 10.1007/s40618-020-01275-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 04/23/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Endocrine neoplasms are generally slow-growing tumors that can show hormonal activity and give metastases. In most cases they are benign and clearly malignant forms are easy to diagnose. However, borderline forms may occur and be, for the pathologists, very difficult to classify. In these cases, there is a strong need to identify factors that may aid. Official classification systems for endocrine neoplasms are based on the evaluation of proliferation and, in most cases, they rely on mitotic count. In support, the study of Ki67 is carried out which, however, has not yet been included in any official classification system, except for neuroendocrine neoplasms of the gastro-entero-pancreatic tract. PURPOSE The aim of the present study was to investigate the proven or unproven role of Ki67 in endocrine neoplasms, in different districts, in order to bring to light the substantial differences, in terms of proliferation, existing between neoplasms so similar, but at the same time, so different. METHODS A thorough search of English language literature was performed, looking for articles concerning Ki67 in five endocrine neoplasms (pituitary adenomas, thyroid neoplasms, adrenocortical neoplasms, pheochromocytomas and paragangliomas). RESULTS From 2170, 236 articles were selected and it was seen that the endocrine neoplasm in which Ki67 was most studied was the pituitary, where it still shows a controversial role. In other neoplasms different roles were identified. CONCLUSION The pathologist should be aware of the contribution that this proliferative marker can give to the diagnosis and, sometimes, to the therapy selection, for the clinician.
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Affiliation(s)
- E Guadagno
- Pathology Section, Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - E D'Avella
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - P Cappabianca
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - A Colao
- Endocrinology Section, Department of Clinic Medicine and Surgery, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - M Del Basso De Caro
- Pathology Section, Department of Advanced Biomedical Sciences, "Federico II" University of Naples, Via Pansini 5, 80131, Naples, Italy
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Sanuvada R, Nandyala R, Chowhan AK, Bobbidi P, Yootla M, Hulikal N, Sachan A. Value of cytokeratin-19, Hector Battifora mesothelial-1 and galectin-3 immunostaining in the diagnosis of thyroid neoplasms. J Lab Physicians 2020; 10:200-207. [PMID: 29692588 PMCID: PMC5896189 DOI: 10.4103/jlp.jlp_106_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND: Diagnosis of types and aggressiveness of thyroid cancers is difficult. The “gold standard” in diagnosis is using routine hematoxylin and eosin staining. Several markers have been investigated for differentiating them among which cytokeratin-19 (CK-19), Hector Battifora mesothelial cell (HBME-1), and galectin-3 are found to be most commonly used. Most studies have evaluated the single expression of markers in various thyroid lesions. AIMS AND OBJECTIVES: To know the value of immunohistochemical expression of CK-19, HBME-1, and galectin-3 in diagnosing thyroid neoplasms. To study the expression and compare the results of HBME-1, CK-19, and galectin-3 immunohistochemical markers in histopathologically diagnosed malignant lesions and nonmalignant lesions and demonstrate their usefulness in differentiating them. MATERIALS AND METHODS: A prospective study was carried out on thyroidectomy specimens sent in 10% buffered formalin to Department of Pathology, SVIMS, Tirupati, from May 2013 to August 2014. Sensitivity and specificity for each marker and their combination in diagnosis were calculated. RESULTS: Among 120 cases, nonmalignant lesions were 70 (58.33%) and malignant lesions 50 (41.67%). Among nonmalignant lesions, 65 (93%) were adenomatous goiter and 5 (7%) were follicular adenomas. In malignant lesions, 48 (96%) were papillary carcinoma and 1 (2%) each of follicular carcinoma and anaplastic carcinoma. Among papillary carcinomas, classical were 26 (54.16%) followed by 17 follicular variant (35.41%). Galectin-3 had highest sensitivity of 90% and HBME-1 had highest specificity of 97.14%. CONCLUSIONS: Panel of HBME-1+ galectin-3 or CK-19, HBME-1, and galectin-3 increase the accuracy of diagnosis in histopathologically difficult cases.
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Affiliation(s)
- Rajasekhar Sanuvada
- Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Rukmangadha Nandyala
- Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Amit Kumar Chowhan
- Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Phaneendra Bobbidi
- Department of Pathology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Mutheeswariah Yootla
- Department of General Surgery, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Narendra Hulikal
- Department of Surgical Oncology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
| | - Alok Sachan
- Department of Endocrinology, Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India
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Abdou AG, Shabaan M, Abdallha R, Nabil N. Diagnostic Value of TROP-2 and CK19 Expression in Papillary Thyroid Carcinoma in Both Surgical and Cytological Specimens. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2019; 12:2632010X19863047. [PMID: 31384753 PMCID: PMC6647210 DOI: 10.1177/2632010x19863047] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 06/18/2019] [Indexed: 12/29/2022]
Abstract
Papillary thyroid carcinoma (PTC) represents the most common primary malignant thyroid tumor and its diagnosis is dependent on the presence of classic nuclear features that are sometimes seen in some non-neoplastic and benign lesions. Several immunohistochemical markers are used individually or in combination to help in differentiation of PTC from mimickers. The aim of the current study was to assess the diagnostic value of TROP-2 and cytokeratin 19 (CK19) expression in differentiating PTC from other mimickers both singly and in combination. The current study was carried out on 77 surgical specimens (56 PTC and 21 non-neoplastic cases) and 12 cytological specimens (4 THY2, 6 THY4, and 2 THY5). TROP-2 was negative in 81% of non-neoplastic surgical specimens and in 100% of THY2 cytological specimens while it was positive in 71.4% of PTC surgical specimens and 100% of THY4/THY5 cytological specimens. Sensitivity and specificity of TROP-2 positive expression for diagnosis of PTC in surgical specimens reached 71% and 81%, respectively, while it reached 100% for both in cytological specimens. Cytokeratin 19 showed positive expression in 85.7% of non-neoplastic surgical specimens and in 92.9% of PTC surgical specimens. Cytokeratin 19 showed negative expression in 75% of Thy2 cases while it was positive in all studied Thy4 and Thy5 cases. Sensitivity and specificity of CK19 total estimated score for diagnosis of PTC in surgical specimens were 78.6% and 66.7%, respectively, while it reached 100% and 75% in cytological specimens. Positive TROP-2 and CK19 expression in PTC were associated with lymph node metastasis. TROP-2 is a specific rather than sensitive marker while CK19 is a sensitive rather than specific marker in differentiating PTC from other mimickers in surgical specimens. The diagnostic validity of both markers was superior in diagnosis of classic PTC compared with follicular variant PTC. TROP-2 is superior to CK19 in diagnosis of PTC in cytological specimens. Both TROP-2 and CK19 could be used preoperatively in adjunct to hematoxylin and eosin for more confident diagnosis of thyroid cytology and along with radiology as predictors of lymph node metastasis.
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Affiliation(s)
- Asmaa Gaber Abdou
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
| | - Mohammed Shabaan
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
| | - Rania Abdallha
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
| | - Nehal Nabil
- Department of Pathology, Faculty of Medicine, Menoufia University, Shebein Elkom, Egypt
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13
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Huang L, Wang X, Huang X, Gui H, Li Y, Chen Q, Liu D, Liu L. Diagnostic significance of CK19, galectin-3, CD56, TPO and Ki67 expression and BRAF mutation in papillary thyroid carcinoma. Oncol Lett 2018. [PMID: 29541194 PMCID: PMC5835856 DOI: 10.3892/ol.2018.7873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The aim of the present study was to examine the rate of BRAF mutation and the expression profiles of CK19, galectin-3, CD56, thyroid peroxidase (TPO) and Ki67 in papillary thyroid carcinoma (PTC) and papillary thyroid micro-carcinoma (PTMC). A total of 246 cases of thyroid disease were collected, including PTC, PTMC, nodular goiter (NG) and Hashimoto thyroiditis (HT). The results revealed that CK19 expression was 116/120 in PTC, 61/64 in PTMC, 2/34 in NG and 1/28 in HT. Galectin-3 positive expression was 115/120 in PTC, 60/64 in PTMC, 6/34 in NG and 4/28 in HT. TPO positive expression was 8/120 in PTC, 1/64 in PTMC, 30/34 in NG and 25/28 in HT. CD56-positive expression was 12/120 in PTC, 3/64 in PTMC, 33/34 in NG and 26/28 in HT. Ki67 labeling index was 2.52±0.46% in PTC (120 cases), 2.62±0.52% in PTMC (64 cases), 2.55±0.44% in NG (34 cases) and 2.58±0.48% in HT (28 cases). BRAF mutation rate was 93/120 in PTC, 47/64 in PTMC, 3/34 in NG and 2/28 in HT. These results suggested that expression patterns of CK19, galectin-3, CD56 and TPO and BRAF mutation exhibit diagnosis value in thyroid disease. However, Ki67-positive rate exhibits no notable diagnosis value in thyroid disease.
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Affiliation(s)
- Lihua Huang
- Department of Pathology, Wuhan Puai Hospital, Wuhan, Hubei 430030, P.R. China
| | - Xuming Wang
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
| | - Xuan Huang
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
| | - Huawei Gui
- Department of Pathology, Wuhan Puai Hospital, Wuhan, Hubei 430030, P.R. China
| | - Yan Li
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
| | - Qiongxia Chen
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
| | - Dongling Liu
- Department of Pathology, Wuhan Puai Hospital, Wuhan, Hubei 430030, P.R. China
| | - Lijiang Liu
- Department of Histopathology, Jiangda Pathology Institute, Jianghan University, Wuhan, Hubei 430056, P.R. China.,Department of Pathology and Pathophysiology, School of Medicine, Jianghan University, Wuhan, Hubei 430056, P.R. China
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Galectin-3 Performance in Histologic a Cytologic Assessment of Thyroid Nodules: A Systematic Review and Meta-Analysis. Int J Mol Sci 2017; 18:ijms18081756. [PMID: 28800068 PMCID: PMC5578146 DOI: 10.3390/ijms18081756] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 08/08/2017] [Accepted: 08/10/2017] [Indexed: 02/07/2023] Open
Abstract
The literature on Galectin-3 (Gal-3) was systematically reviewed to achieve more robust information on its histologic reliability in identifying thyroid cancers and on the concordance between Gal-3 test in histologic and cytologic samples. A computer search of the PubMed and Scopus databases was conducted by combinations of the terms thyroid and Gal-3. Initially, 545 articles were found and, after their critical review, 52 original papers were finally included. They reported 8172 nodules with histologic evaluation of Gal-3, of which 358 with also preoperative FNAC Gal-3 assessment. At histology, Gal-3 sensitivity was 87% (95% confidence intervals [CI] from 86% to 88%), and specificity 87% (95% CI from 86% to 88%); in both cases, we found heterogeneity (I2 85% and 93%, respectively) and significant publication bias (p < 0.001). The pooled rate of positive Gal-3 at fine needle aspiration (FNAC) among cancers with histologically proven Gal-3 positivity was 94% (95% CI from 89% to 97%), with neither heterogeneity (I2 14.5%) nor bias (p = 0.086). These data show high reliability of Gal-3 for thyroid cancer at histology, while its sensitivity on FNAC samples is lower. The limits of cytologic preparations and interpretation of Gal-3 results have to be solved.
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Xin Y, Guan D, Meng K, Lv Z, Chen B. Diagnostic accuracy of CK-19, Galectin-3 and HBME-1 on papillary thyroid carcinoma: a meta-analysis. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2017; 10:8130-8140. [PMID: 31966665 PMCID: PMC6965469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 05/20/2017] [Indexed: 06/10/2023]
Abstract
The study aimed at evaluating the diagnostic accuracy of cytokeratin 19 (CK-19), Galectin-3 and hector battifora mesothelial antigen-1 (HBME-1) for papillary thyroid carcinoma (PTC). The eligible studies were searched in relevant databases with predefined key searching terms and inclusion criteria. Then, the quality assessment was performed by using Diagnostic Accuracy Studies scoring tool. Following the heterogeneity test, a meta-analysis of pooled several effect size including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR) with their 95% confidence intervals (CIs) were conducted by Meta-DiSc software. Next, the summary receiver operating characteristic ROC (SROC) curve was drawn. Total 29 studies with high quality were included in this meta-analysis. The pooled result of CK-19 showed that sensitivity, specificity, PLR, NLR and DOR were 0.816 (95% CI: 0.799-0.832), 0.872 (95% CI: 0.855-0.888), 5.900 (95% CI: 5.193-6.703), 0.205 (95% CI: 0.185-0.228), respectively. For Galectin-3, the pooled sensitivity, specificity, PLR, NLR and DOR were 0.842 (95% CI: 0.825-0.858), 0.833 (95% CI: 0.814-0.851), 5.057 (95% CI: 4.494-5.690), 0.176 (95% CI: 0.154-0.200) and 33.312 (95% CI: 26.403-42.029). For HBME-1, the pooled sensitivity, specificity, PLR, NLR and DOR were 0.928 (95% CI: 0.913-0.941), 0.864 (95% CI: 0.847-0.880), 6.204 (95% CI: 5.498-7.002), 0.082 (95% CI: 0.067-0.102), 57.107 (95% CI: 43.421-75.107), respectively. The area under curve (AUC) value in SROC curve of CK-19, Galectin-3 and HBME-1 were 0.9134 (95% CI: 0.877-0.950), 0.8452 (95% CI: 0.809-0.882) and 0.9047 (95% CI: 0.868-0.941), respectively. Compared with CK-19 and Galectin-3, HBME-1 was a more accurate maker and might be used independently for PTC diagnosis. CK-19 and Galectin-3 might as second-line detection for PTC diagnosis.
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Affiliation(s)
- Ying Xin
- Department of Thyroid & Breast Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical CollegeHangzhou 310014, Zhejiang, China
| | - Dandan Guan
- Department of Thyroid & Breast Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical CollegeHangzhou 310014, Zhejiang, China
| | - Kexin Meng
- Department of Thyroid & Breast Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical CollegeHangzhou 310014, Zhejiang, China
| | - Zhenye Lv
- Department of Thyroid & Breast Surgery, Zhejiang Provincial People’s Hospital, People’s Hospital of Hangzhou Medical CollegeHangzhou 310014, Zhejiang, China
| | - Bin Chen
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hangzhou Hospital of Nanjing Medical UniversityHangzhou 310006, Zhejiang, China
- Department of Hepatopancreatobiliary Surgery, The Affiliated Hospital of Hangzhou Normal UniversityHangzhou 310015, Zhejiang, China
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Pan DH, Wen DY, Luo YH, Chen G, Yang H, Chen JQ, He Y. The diagnostic and prognostic values of Ki-67/MIB-1 expression in thyroid cancer: a meta-analysis with 6,051 cases. Onco Targets Ther 2017; 10:3261-3276. [PMID: 28740401 PMCID: PMC5505609 DOI: 10.2147/ott.s135593] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background Growing evidence has demonstrated that Ki-67/MIB-1 has an effect on the clinical progression and prognosis in cancers. However, the diagnostic and prognostic values of Ki-67/MIB-1 in thyroid cancer remain unclear. Materials and methods The meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies were retrieved from PubMed, EBSCO, EMBASE, ISI Web of Science, China National Knowledge Infrastructure, WanFang and Chinese VIP databases. MetaDiSc and STATA12.0 were used to analyze the meta-analysis. Fixed-effect analysis and random-effect analysis were applied to pool the relative ratio based on heterogeneity in this meta-analysis. Results In the meta-analysis, 51 eligible studies were included. The pooled sensitivity of Ki-67/MIB-1 was 0.61 (95% confidence interval [CI]: 0.59–0.63) and specificity was 0.75 (95% CI: 0.74–0.77) in thyroid cancer. The pooled positive likelihood ratio was 3.19 (95% CI: 2.30–4.42) and negative likelihood ratio was 0.43 (95% CI: 0.35–0.54). In the diagnosis of thyroid cancer, the pooled diagnostic odds ratio of Ki-67/MIB-1 was 8.54 (95% CI: 5.03–14.49). The area under the symmetric receiver operating characteristic curve was 0.804 (standard error =0.031). Our results showed that there were statistical associations between Ki-67/MIB-1 and age (odds ratio [OR] =1.71, 95% CI: 1.14–2.57, P=0.010), tumor size (OR =1.86, 95% CI: 1.17–2.96, P=0.008), lymph node metastasis (OR =2.49, 95% CI: 1.42–4.39, P=0.002), metastasis status (OR =6.96, 95% CI: 2.46–19.69, P<0.001), tumor node metastasis stage (OR =6.56, 95% CI: 3.80–11.34, P<0.001) and extrathyroid extension (OR =1.91, 95% CI: 1.27–2.87, P=0.002). Furthermore, thyroid cancer patients with a high level of Ki-67/MIB-1 had a worse disease-free survival as compared to patients with a low level of Ki-67/MIB-1 (hazard ratio =5.19, 95% CI: 3.18–8.46, P<0.001). Also, Ki-67/MIB-1 was found to be associated with increased risk of mortality (hazard ratio =3.56, 95% CI: 1.17–10.83, P=0.025). Conclusion Our results demonstrated that Ki-67/MIB-1 might act as a potential factor in diagnosing thyroid cancer in Chinese. Also, the meta-analysis indicated that Ki-67/MIB-1 might have an effect on prognosis in non-Chinese thyroid cancer patients.
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Affiliation(s)
| | | | | | - Gang Chen
- Department of Pathology, First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, People's Republic of China
| | | | | | - Yun He
- Department of Ultrasonography
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17
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Diagnostic utility of CK19 and CD56 in the differentiation of thyroid papillary carcinoma from its mimics. Pathol Res Pract 2017; 213:509-517. [DOI: 10.1016/j.prp.2017.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 01/02/2017] [Accepted: 01/19/2017] [Indexed: 11/23/2022]
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18
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Noroozinia F, Gheibi A, Ilkhanizadeh B, Abbasi A. CK19 IS A USEFUL MARKER IN DISTINGUISHING FOLLICULAR VARIANT OF PAPILLARY THYROID CARCINOMA FROM BENIGN THYROID LESIONS WITH FOLLICULAR GROWTH PATTERN. ACTA ENDOCRINOLOGICA-BUCHAREST 2016; 12:387-391. [PMID: 31149120 DOI: 10.4183/aeb.2016.387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Context Thyroid cancer is the most common endocrine malignancy. Within various subtypes of thyroid neoplasms, those with follicular growth pattern usually make diagnostic problems. Objective To examine ck19 expression as a diagnostic marker in thyroid neoplasms with follicular growth pattern. Design In this cross sectional study, 86 patients were enrolled. Subjects and Methods Totally 22 follicular adenoma (FA), 18 well differentiated tumors with undetermined malignant potential (WT-UMP) and 46 follicular variants of papillary thyroid carcinoma (FV-PTC) were enrolled and examined for Ck19 expression by immunohistochemistry staining. Membranous/cytoplasmic staining patterns were considered as positive. Specimens without staining were considered as 0, < 5% positively stained cells as 1+, 5%-25% as 2+, 25%-75% as 3+ and >75% as 4+. Result CK19 was negative in most cases of FA while positive in most WDT-UMP and FV-PTCs, p<0.001. Additionally, most cases with 2+ and 3+ staining patterns were FV-PTC (75% and 81%, respectively, p<0.001) and none of FAs showed 3+ positivity (p<0.001). Additionally, most of strongly positive results in patients > 45 y/o were PTC (p<0.001). Conclusion Ck19 is a useful marker in differentiating FA from FV-PTC. We found diffuse and strong (3+) staining pattern in FV-PTC but none of FAs were so. We concluded that diffuse and strong staining for ck19 in a thyroid lesion with follicular pattern of growth, especially in a patient older than 45 y/o should raise the possibility of malignancy.
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Affiliation(s)
- F Noroozinia
- Urmia University of Medical Sciences, Department of Pathology, Urmia, Iran
| | - A Gheibi
- Urmia University of Medical Sciences, Department of Pathology, Urmia, Iran
| | - B Ilkhanizadeh
- Urmia University of Medical Sciences, Department of Pathology, Urmia, Iran
| | - A Abbasi
- Urmia University of Medical Sciences, Department of Pathology, Urmia, Iran
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19
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Guan M, Ma Y, Shah SR, Romano G. Thyroid malignant neoplasm-associated biomarkers as targets for oncolytic virotherapy. Oncolytic Virother 2016; 5:35-43. [PMID: 27579295 PMCID: PMC4996252 DOI: 10.2147/ov.s99856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Biomarkers associated with thyroid malignant neoplasm (TMN) have been widely applied in clinical diagnosis and in research oncological programs. The identification of novel TMN biomarkers has greatly improved the efficacy of clinical diagnosis. A more accurate diagnosis may lead to better clinical outcomes and effective treatments. However, the major deficiency of conventional chemotherapy and radiotherapy is lack of specificity. Due to the macrokinetic interactions, adverse side effects will occur, including chemotherapy and radiotherapy resistance. Therefore, a new treatment is urgently needed. As an alternative approach, oncolytic virotherapy may represent an opportunity for treatment strategies that can more specifically target tumor cells. In most cases, viral entry requires the expression of specific receptors on the surface of the host cell. Currently, molecular virologists and gene therapists are working on engineering oncolytic viruses with altered tropism for the specific targeting of malignant cells. This review focuses on the strategy of biomarkers for the production of novel TMN oncolytic therapeutics, which may improve the specificity of targeting of tumor cells and limit adverse effects in patients.
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Affiliation(s)
- Mingxu Guan
- Virology, Research and Development, Zoetis Inc., Kalamazoo, MI, USA
| | - Yanping Ma
- Virology Laboratory, Shengjing Hospital, China Medical University, Shenyang, Liaoning, People's Republic China
| | - Sahil Rajesh Shah
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA
| | - Gaetano Romano
- Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA
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Lamba Saini M, Bouzin C, Weynand B, Marbaix E. An Appraisal of Proliferation and Apoptotic Markers in Papillary Thyroid Carcinoma: An Automated Analysis. PLoS One 2016; 11:e0148656. [PMID: 26863116 PMCID: PMC4749175 DOI: 10.1371/journal.pone.0148656] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 01/21/2016] [Indexed: 02/07/2023] Open
Abstract
Introduction Proliferation and apoptosis are opposing processes by which the cell numbers are kept in a delicate balance, essential for tissue homeostasis, whereas uncontrolled growth of cells is a hallmark of cancer. Papillary thyroid cancer (PTC) is the commonest type of thyroid cancer, with some PTC following an indolent course, whereas the other ones are more aggressive. Aim To evaluate respective contribution of proliferation and apoptosis in the tumorigenesis of PTC by automated analysis. Materials and Methods We investigated the immunolabeling of phosphorylated histone H3 (pHH3), cyclin D1, active caspase-3, and bcl-2 in thirteen cases each of metastatic PTC, follicular variant of PTC (FVPTC), papillary microcarcinoma (PMC) and well differentiated tumor of uncertain malignant potential (WDT-UMP). FVPTC cases comprised seven encapsulated and six unencapsulated cases. Results Proliferation, as assessed by pHH3 and cyclin D1 immunolabeling, was increased in all PTC variants, including the putative precursor lesion WDT-UMP, compared to normal thyroid tissue. pHH3 was immunolabeled in more cells of metastatic PTC than of PMC and of encapsulated FVPTC. Surprisingly, metastatic PTC and unencapsulated FVPTC also demonstrated more cleaved caspase-3 immunolabeled cells than the other types. In contrast, increased expression of bcl-2 protein was seen in normal thyroid areas, encapsulated FVPTC and PMC as compared to metastatic PTC. Metastatic PTC shows higher proliferation than other types of PTC but unexpectedly also higher apoptotic levels. Similar results were also seen with unencapsulated FVPTC, thus suggesting that unencapsulated FVPTC has a potential for adverse outcome. Bcl-2 was immunolabeled in a low percentage of cells in WDT-UMP. Conclusions The expression of the proliferative protein pHH3 together with the apoptotic marker cleaved caspase-3 may indicate an aggressive behaviour of PTC and loss of apoptosis inhibition by bcl-2 protein can further amplify the role of these proteins in tumor progression. Both cyclin D1 and bcl-2 could prove to be interesting markers of PTC precursor lesions. Automated/digital image quantification approach helps in refining the diagnostic accuracy.
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Affiliation(s)
- Monika Lamba Saini
- Service d'anatomie pathologique, Cliniques universitaires Saint-Luc, and Institut de Duve, Université catholique de Louvain, Avenue Hippocrate, 10 T-1, B-1200, Bruxelles, Belgium
- * E-mail: ;
| | - Caroline Bouzin
- IREC Imaging Platform (2IP), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium
| | - Birgit Weynand
- Pathologische Ontleedkunde, Universitair Ziekenhuis Leuven, Herestraat, 49, B-3000, Leuven, Belgium
| | - Etienne Marbaix
- Service d'anatomie pathologique, Cliniques universitaires Saint-Luc, and Institut de Duve, Université catholique de Louvain, Avenue Hippocrate, 10 T-1, B-1200, Bruxelles, Belgium
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Dunđerović D, Lipkovski JM, Boričic I, Soldatović I, Božic V, Cvejić D, Tatić S. 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. Diagn Pathol 2015; 10:196. [PMID: 26503236 PMCID: PMC4624378 DOI: 10.1186/s13000-015-0428-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/17/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Nodular 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. METHODS Tissue 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. RESULTS All 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. CONCLUSION Galectin 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.
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Affiliation(s)
- Duško Dunđerović
- Institute of Pathology, Faculty of Medicine, University of Belgrade, dr Subotica 1, 11000, Belgrade, Serbia.
| | - Jasmina Marković Lipkovski
- Institute of Pathology, Faculty of Medicine, University of Belgrade, dr Subotica 1, 11000, Belgrade, Serbia.
| | - Ivan Boričic
- Institute of Pathology, Faculty of Medicine, University of Belgrade, dr Subotica 1, 11000, Belgrade, Serbia.
| | - Ivan Soldatović
- Faculty of Medicine, University of Belgrade, dr Subotica 8, 11000, Belgrade, Serbia.
| | - Vesna Božic
- Department of Pathology, Centre for Endocrine Surgery, Clinic for Diabetes and Metabolic Diseases, Clinical Center of Serbia, Dr. Koste Todorovića 8, 11000, Belgrade, Serbia.
| | - Dubravka Cvejić
- Institute for the application of nuclear energy, Belgrade, Serbia, Banatska 31b, Zemun, 11080, Zemun, Serbia.
| | - Svetislav Tatić
- Institute of Pathology, Faculty of Medicine, University of Belgrade, dr Subotica 1, 11000, Belgrade, Serbia.
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Integrative metabonomics as potential method for diagnosis of thyroid malignancy. Sci Rep 2015; 5:14869. [PMID: 26486570 PMCID: PMC4613561 DOI: 10.1038/srep14869] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 09/10/2015] [Indexed: 12/22/2022] Open
Abstract
Thyroid nodules can be classified into benign and malignant tumors. However, distinguishing between these two types of tumors can be challenging in clinics. Since malignant nodules require surgical intervention whereas asymptomatic benign tumors do not, there is an urgent need for new techniques that enable accurate diagnosis of malignant thyroid nodules. Here, we used 1H NMR spectroscopy coupled with pattern recognition techniques to analyze the metabonomes of thyroid tissues and their extracts from thyroid lesion patients (n = 53) and their adjacent healthy thyroid tissues (n = 46). We also measured fatty acid compositions using GC−FID/MS techniques as complementary information. We demonstrate that thyroid lesion tissues can be clearly distinguishable from healthy tissues, and malignant tumors can also be distinguished from the benign tumors based on the metabolic profiles, both with high sensitivity and specificity. In addition, we show that thyroid lesions are accompanied with disturbances of multiple metabolic pathways, including alterations in energy metabolism (glycolysis, lipid and TCA cycle), promotions in protein turnover, nucleotide biosynthesis as well as phosphatidylcholine biosynthesis. These findings provide essential information on the metabolic features of thyroid lesions and demonstrate that metabonomics technology can be potentially useful in the rapid and accurate preoperative diagnosis of malignant thyroid nodules.
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Li M, Song Q, Li H, Lou Y, Wang L. Circulating miR-25-3p and miR-451a May Be Potential Biomarkers for the Diagnosis of Papillary Thyroid Carcinoma. PLoS One 2015; 10:e0132403. [PMID: 26168287 PMCID: PMC4500410 DOI: 10.1371/journal.pone.0132403] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 06/12/2015] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE There is no effective and reliable biomarker to distinguish benign thyroid nodules from papillary thyroid carcinomas (PTC). This study aimed at examining the levels of plasma miRNAs in patients with PTC or benign nodules to explore the potential miRNA biomarkers for PTC. PATIENTS AND METHODS Genome-wide plasma miRNA expression profiles were determined by the miRNA Microarray and the significantly higher levels of miRNAs were validated in plasma and tissues by quantitative RT-PCR. The levels of two miRNAs were further tested in seven patients before and after tumor excision and the potential values for the diagnosis of PTC were evaluated by receiver operating characteristic curve (ROC). RESULTS In comparison with that in the patients with benign nodules, eight significantly higher and three lower levels of plasma miRNAs were detected in the PTC patients. Further validation indicated that the levels of plasma miR-25-3p, miR-451a, miR-140-3p and let-7i were significantly higher in the PTC cases than in those with benign nodules or the healthy controls. Significantly higher levels of miR-25-3p and miR-451a were detected in the thyroid tissues from the PTC patients. The levels of plasma miR-25-3p and miR-451a in seven patients significantly decreased after tumor excision. ROC analyses revealed that the levels of plasma miR-25-3p at cut-off 1.41 and miR-451a at 1.38 had sensitivity of 92.8% and 88.9%, and specificity of 68.8% and 66.7% for distinguishing PTC from benign nodules, respectively. CONCLUSION Our findings suggest that the levels of plasma miR-25-3p and miR-451a may be valuable for the diagnosis of PTC.
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Affiliation(s)
- Min Li
- Department of Endocrinology, the First Affiliated Hospital, China Medical University, Shenyang, 110001, China
| | - Qinbin Song
- Department of Thyroid Surgery, the First Affiliated Hospital, China Medical University, Shenyang, 110001, China
- * E-mail:
| | - Hang Li
- Department of Thyroid Surgery, the First Affiliated Hospital, China Medical University, Shenyang, 110001, China
| | - Yi Lou
- Department of Genetics, China Medical University, Shenyang, 110001, China
| | - Lili Wang
- Medical Research Center of Shengjing Hospital, China Medical University, Shenyang, 110004, China
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Liu Z, Yu P, Xiong Y, Zeng W, Li X, Maiaiti Y, Wang S, Song H, Shi L, Liu C, Cheng B, Zhang B, Ming J, Dong F, Ge H, Nie X, Huang T. Significance of CK19, TPO, and HBME-1 expression for diagnosis of papillary thyroid carcinoma. Int J Clin Exp Med 2015; 8:4369-4374. [PMID: 26064355 PMCID: PMC4443189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 01/10/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To evaluate the expression and significance of CK19, TPO, and HBME-1 in the differential diagnosis of papillary thyroid carcinoma (PTC) and nonmalignant nodules. METHODS Tissue samples were obtained from 257 patients with PTC and 149 patients with nonmalignant thyroid specimens, and immunohistochemical staining for CK-19, TPO, and HBME-1 was performed. RESULTS The expression of CK-19, TPO, and HBME-1 was 96.3%, 12.0%, and 85.3%, respectively, for the PTC group. For nonmalignant thyroid lesions group, the expression of these markers was 40.4%, 86.2%, and 37.2%, respectively. Further, the expression of CK-19 and HBME-1 in PTCs was much higher than that in the benign thyroid lesions (P < 0.05). However, the positive expression of TPO in PTC specimens was much lower than that in the nonmalignant specimens (P < 0.05). CK-1 had the highest sensitivity (96.30%) for PTCs. The combination of the positive expression of CK-19 and negative expression of TPO had the highest sensitivity (98.50%), while that of the positive expression of HBME-1 and negative expression of TPO had the highest specificity (92.90%). CONCLUSIONS The combination of positive expression of CK-19 or HBME-1 or negative expression of TPO can improve the specificity of the diagnosis of PTC.
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Affiliation(s)
- Zeming Liu
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Pan Yu
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Yiquan Xiong
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Wen Zeng
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, Hubei, China
| | - Xiaoyu Li
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Yusufu Maiaiti
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Shuntao Wang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Haiping Song
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Lan Shi
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Chunping Liu
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Bo Cheng
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Bo Zhang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Jie Ming
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Fang Dong
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
| | - Hui Ge
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, China
| | - Xiu Nie
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, China
| | - Tao Huang
- Department of Breast and Thyroid Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science And TechnologyWuhan, People’s Republic of China
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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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Utility of immunohistochemical markers in diagnosis of follicular cell derived thyroid lesions. Pathol Oncol Res 2014; 20:819-28. [PMID: 24659044 DOI: 10.1007/s12253-014-9760-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 03/06/2014] [Indexed: 02/08/2023]
Abstract
Differentiating the follicular derived lesions can be challenging. Although immunohistochemistry is generally accepted as a useful ancillary technique in the diagnosis, controversy exists regarding the best marker or combination of markers to distinguish each lesion from its mimics. In this study, we aimed at evaluating multiple markers to compare their sensitivity and usefulness, and to find out if a combination of the evaluated markers can be of additional value in discriminating thyroid lesions. The study included two groups of follicular derived thyroid lesions; benign group (Grave's disease, nodular goiter, Hashimoto's and adenoma) and malignant group (papillary, follicular carcinoma, well differentiated tumors of unknown malignant potential and follicular tumour of unknown malignant potential). Immunohistochemical evaluation of CD56, HBME-1, Gaectin-3 and CK19 were done. The sensitivity, specificity for each marker and their combination were calculated. Each marker was sensitive and specific for certain lesion but the sensitivity and specificity was increased when use combination of markers. Although no single marker is completely sensitive and specific for follicular thyroid lesions, the combination of CD56, HBME-1, Gaectin-3 and CK19 attains high sensitivity and specificity in diagnosis.
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Zhang B, Liu S, Zhang Z, Wei J, Qu Y, Wu K, Yang Q, Hou P, Shi B. Analysis of BRAF(V600E) mutation and DNA methylation improves the diagnostics of thyroid fine needle aspiration biopsies. Diagn Pathol 2014; 9:45. [PMID: 24588959 PMCID: PMC3944809 DOI: 10.1186/1746-1596-9-45] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/21/2014] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Thyroid nodules with indeterminate cytological features on fine needle aspiration biopsy specimens (FNABs) have a ~20% risk of thyroid cancer. BRAF(V600E) mutation and DNA methylation are useful markers to distinguish malignant thyroid neoplasm from benign. The aim of this study was to determine whether combined detection of BRAF(V600E) mutation and methylation markers on FNABs could improve the diagnostic accuracy of thyroid cancer. METHODS Using pyrosequencing and quantitative methylation-specific PCR (Q-MSP) methods, FNABs from 79 and 38 patients with thyroid nodules in training and test groups, respectively, were analyzed for BRAF(V600E) mutation and gene methylation. RESULTS BRAF(V600E) mutation was found in 30/42 (71.4%) and 14/20 (70%) FNABs in training and test groups, respectively. All BRAF(V600E)-positive samples were histologically diagnosed as papillary thyroid cancer (PTC) after thyroidectomy. As expected, BRAF mutation was not found in all benign nodules. Moreover, we demonstrated that the five genes, including CALCA, DAPK1, TIMP3, RAR-beta and RASSF1A, were aberrantly methylated in FNABs. Of them, methylation level of DAPK1 in PTCs was significantly higher than that in benign samples (P <0.0001). Conversely, methylation level of RASSF1A in PTCs was significantly lower than that in benign samples (P =0.003). Notably, compared with BRAF mutation testing alone, combined detection of BRAF mutation and methylation markers increased the diagnostic sensitivity and accuracy of PTC with excellent specificity. CONCLUSION Our data have demonstrated that combine analysis of BRAF mutation and DNA methylation markers on FNABs may be a useful strategy to facilitate the diagnosis of malignant thyroid neoplasm, particularly PTC. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6080878071149177.
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Affiliation(s)
| | | | | | | | | | | | | | - Peng Hou
- Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University School of Medicine, Xi'an 710061, P, R, China.
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Alshenawy H. Utility of immunohistochemical markers in differential diagnosis of follicular cell-derived thyroid lesions. J Microsc Ultrastruct 2014. [DOI: 10.1016/j.jmau.2014.02.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Toegel S, Bieder D, André S, Altmann F, Walzer SM, Kaltner H, Hofstaetter JG, Windhager R, Gabius HJ. Glycophenotyping of osteoarthritic cartilage and chondrocytes by RT-qPCR, mass spectrometry, histochemistry with plant/human lectins and lectin localization with a glycoprotein. Arthritis Res Ther 2013; 15:R147. [PMID: 24289744 PMCID: PMC3978707 DOI: 10.1186/ar4330] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 09/12/2013] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION This study aimed to characterize the glycophenotype of osteoarthritic cartilage and human chondrocytes. METHODS Articular knee cartilage was obtained from nine osteoarthritis (OA) patients. mRNA levels for 27 glycosyltransferases were analyzed in OA chondrocytes using RT-qPCR. Additionally, N- and O-glycans were quantified using mass-spectrometry. Histologically, two cartilage areas with Mankin scores (MS) either ≤ 4 or ≥ 9 were selected from each patient representing areas of mild and severe OA, respectively. Tissue sections were stained with (1) a selected panel of plant lectins for probing into the OA glycophenotype, (2) the human lectins galectins-1 and -3, and (3) the glycoprotein asialofetuin (ASF) for visualizing β-galactoside-specific endogenous lectins. RESULTS We found that OA chondrocytes expressed oligomannosidic structures as well as non-, mono- and disialylated complex-type N-glycans, and core 2 O-glycans. Reflecting B4GALNT3 mRNA presence in OA chondrocytes, LacdiNAc-terminated structures were detected. Staining profiles for plant and human lectins were dependent on the grade of cartilage degeneration, and ASF-positive cells were observed in significantly higher rates in areas of severe degeneration. CONCLUSIONS In summary, distinct aspects of the glycome in OA cartilage are altered with progressing degeneration. In particular, the alterations measured by galectin-3 and the pan-galectin sensor ASF encourage detailed studies of galectin functionality in OA.
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Buchwalow I, Boecker W, Wolf E, Samoilova V, Tiemann M. Signal amplification in immunohistochemistry: loose-jointed deformable heteropolymeric HRP conjugates vs. linear polymer backbone HRP conjugates. Acta Histochem 2013; 115:587-94. [PMID: 23351717 DOI: 10.1016/j.acthis.2012.12.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Revised: 12/16/2012] [Accepted: 12/17/2012] [Indexed: 12/29/2022]
Abstract
Improvements in reagents and protocols for immunohistochemistry have led to increased sensitivity of detection systems. A significant level of signal amplification was achieved by the chain-polymer conjugate technology utilizing enzyme-labeled inert "backbone" molecule of dextran (Dako). However, the relatively large size of the dextran molecule in aqueous phase appears to create spatial hindrance compromising the penetrative ability of the detection reagent. Novel AmpliStain™ detection systems (SDT GmbH, Baesweiler, Germany) seem to overcome these constraints offering a more compact and deformable conjugate design that facilitates agile penetration through the narrowest diffusion pathways in tissue sections. Here, we compared the level of signal amplification achievable with AmpliStain™-HRP (SDT) and EnVision™+-HRP (Dako). Our results show that the AmpliStain™-HRP systems allow higher dilutions of primary antibodies in both immunohistochemistry and ELISA. Compared with EnVision™+, anti-mouse AmpliStain™ enables at least three times more sensitive detection of mouse antibodies, whereas anti-rabbit AmpliStain™ is ten times more sensitive than anti-rabbit EnVision™+.
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Affiliation(s)
- Igor Buchwalow
- Institute for Hematopathology, Fangdieckstr. 75a, 22547 Hamburg, Germany.
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Amal B, El Fatemi H, Souaf I, Moumna K, Affaf A. A rare primary tumor of the thyroid gland: report a new case of leiomyosarcoma and literature review. Diagn Pathol 2013; 8:36. [PMID: 23445571 PMCID: PMC3599845 DOI: 10.1186/1746-1596-8-36] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 02/20/2013] [Indexed: 02/06/2023] Open
Abstract
Primary leiomyosarcomas of the thyroid gland are extremely rare. we report a case of a 72 year-old women with a painful growing mass of the left neck with skin fistula. The patient underwent a lobectomy. The tumor histology showed spindle-shaped cells arranged in interlacing fascicles that expressed desmine and Hcaldesmone, but were negative for cytokeratins and thyroglobulin. Total body CT scan didnt show any other tumor. The patient died two months after surgery. Primary thyroid leiomyosarcoma may be mistaken for other tumors, such as anaplastic or medullary carcinomas. Therefore, the diagnosis is difficult and requires numerous clinical, radiological, and pathological investigations.
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Affiliation(s)
- Bennani Amal
- Departement of pathology, Hassan II University Hospital, Fez 30000, Morocco.
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Xue L, Luan Z, Liu Y, Zou S, Jiang J, Wu N, Lu N, Lin D. Pulmonary metastasis of a papillary thyroid carcinoma and primary lung adenocarcinoma: two coincident carcinomas at the same location. Diagn Pathol 2013; 8:26. [PMID: 23414265 PMCID: PMC3599127 DOI: 10.1186/1746-1596-8-26] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 02/10/2013] [Indexed: 02/07/2023] Open
Abstract
Tumor-to-tumor metastasis is a fairly rare phenomenon. The lung cancers are the most common donors, but are exceedingly rare as recipients. Here we report a case of a lung adenocarcinoma acting as the recipient of papillary thyroid carcinoma, with multiple spreading foci of the two cancers in the lung simultaneously. The morphology and immunohistochemistry (Napsin-A, Thyroglobulin) are very important in differential diagnosis of lung primary adenocarcinoma and metastatic papillary thyroid carcinoma. VIRTUAL SLIDES The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2069496615891134.
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Affiliation(s)
- Liyan Xue
- Department of Pathology, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Zhonghua Luan
- Department of Pathology, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Department of Pathology, Yuncheng Central Hospital, Yuncheng, Shanxi Province, China
| | - Ying Liu
- Department of Nuclear Medicine, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuangmei Zou
- Department of Pathology, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Jiang
- Department of Imaging Diagnosis, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ning Wu
- Department of Nuclear Medicine, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Department of Imaging Diagnosis, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Ning Lu
- Department of Pathology, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Dongmei Lin
- Department of Pathology, Cancer Institute (Hospital), Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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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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