Immunohistochemical Expression of HBME-1 and TROP-2 in Some Follicular-Derived Thyroid Lesions

BACKGROUND AND OBJECTIVES

Detecting thyroid tumors depends on histologic characteristics. However, distinguishing malignant from benign thyroid abnormalities may be challenging and contentious, particularly in tumors with a follicular appearance. Therefore, immunohistochemistry might be useful and essential. Immunohistochemical biomarkers, such as human trophoblast cell surface antigen (TROP) and Hector Battifora Mesothelial-1 (HBME-1), have helped diagnose thyroid cancers. In addition, mesothelial cells have an antigen called HBME-1 on their membranes, but its role is unclear. Thyroid epithelial neoplasms have lately been studied, and TROP-2 is a helpful marker of these tumors. Recently, researchers have explored HBME-1 upregulation in benign and malignant thyroid tumors. This research aimed to show that the immunohistochemical biomarkers TROP-2 and HBME-1 might be employed to distinguish malignant from benign follicular-derived thyroid lesions.

MATERIALS AND METHODS

The research consisted of 50 specimens of various follicular thyroid lesions. From October 2018 to March 2021, blocks of follicular thyroid lesions and clinical information were collected from the Pathology Departments of Al-Azhar University Hospitals. Additionally, the HBME-1 and TROP-2 antigens were stained immunohistochemically.

RESULTS

Expression of TROP-2 along with HBME-1 distinguished benign from malignant follicular-derived thyroid lesions with respective sensitivities of 74.2 and 87.1% and specificities of 84.2 and 78.9%. Furthermore, positive HBME-1 expression was significantly less prevalent in benign lesions (15.8%) than in malignant lesions (74.2%) (P-value <0.001). Moreover, positive TROP-2 expression was significantly lower in benign lesions (21.1%) than in malignant lesions (87.1%) (P-value <0.001). The P value of <0.001 indicated an extremely strong positive correlation between HBME-1 and TROP-2 expression across all instances investigated.

CONCLUSION

With high sensitivity and specificity, both HBME-1 and TROP-2 are beneficial in identifying thyroid cancer, particularly papillary carcinoma, and separating malignant follicular-derived thyroid lesions from benign ones.

To Freeze or Not to Freeze? Recommendations for Intraoperative Examination and Gross Prosection of Thyroid Glands

The use of intraoperative consultation for indeterminate thyroid lesions is not advocated but is still requested by some surgeons. Obscured cytomorphology and nonrepresentative sampling limit the specificity of intraoperative assessment. Formalin fixation of thyroid glands before sectioning also minimizes artifacts introduced by fresh sectioning. Inking of thyroid may vary based on institutional preferences and information desired by clinical teams. Sectioning may occur in the conventional transverse method or the modified transverse vertical method to more thoroughly evaluate the lesion's periphery. Gross examination of thyroid lesions should always consider possible high-grade features, such as necrosis or extrathyroidal extension.