Application of HMWCK, CK19 and Galectin-3 as Immuno Histochemical Markers in the differential diagnosis of thyroid lesions

Abstract

Introduction: Thyroid neoplasms constitute the most common of all endocrine neoplasms occurring worldwide and more than 95% arise from follicular epithelial cells. Thyroid tumors are more common in developed countries. The incidence of thyroid tumors has increased in past two decades.Aim: to assess the role of Galectin-3 in differentiating benign and malignant thyroid lesions along and combined use of CK-19 and HMW-CK in the differential diagnosis between papillary carcinoma and follicular carcinoma.Material and methods: The present study was conducted in 50 specimens of thyroid tissue received in the Department of Pathology, Government Medical College, Amritsar, after approval from the Institutional Ethics Committee. IHC staining was done using Galectin-3, CK-19 and HMW-CK immuno Histochemical markers. The IHC score was calculated by combining an estimate of the percentage of immunoreactive cells (quantity score) with an estimate of the staining intensity (staining intensity score).Results: Incidence of thyroid nodules most common in the age group between 20-40 years comprising about 66% of the total cases followed by 41-60 years. Females constituted about 74% (37 cases) in contrast to males with 13 cases comprising 26%. Prevalence of benign Lesions of thyroid was slightly higher 29 (58%) in comparison to malignant lesions which comprised of 21 (42%) of the study sample. Galactein 3 is found to be the most sensitive marker while HMWCK is found to be the most specific marker in distinguishing malignant thyroid lesions from benign thyroid lesions in present study. CK-19 and HMW CK when combined together in absence of Galactein 3 shows 100% sensitivity and high specificity in diagnosing malignant thyroid lesions. These combinations show increased specificity and positive predictive value compared to Galactein 3 when used alone.Conclusion: Therefore we can say that these immuno histochemical panels can be a useful means to increases the likelihood of detecting malignant tumors. These markers along with histopathological diagnosis can aid us in correct diagnosis and thus further help to optimize the management of patients with thyroid nodules and reduce unnecessary surgical resection of benign nodules.