Abstract
Distinction between benign and malignant thyroid tumors is essential for proper clinical management. The aim of this study was to evaluate the diagnostic potential of a set of 3 molecular markers in the differential diagnosis of thyroid tumors. Immunohistochemistry for HBME-1, E-cadherin (E-CAD), and CD56 was carried out in 36 follicular adenomas, 77 colloid goiters, 36 papillary thyroid carcinomas, and 14 follicular carcinomas. Sixty-eight thyroid fine needle aspiration (FNA) cases confirmed by subsequent surgical resection specimens were selected. Immunocytochemistry for HBME-1, E-CAD, and CD56 was performed in these cases, including 25 papillary thyroid carcinomas, 1 follicular carcinoma, 22 follicular adenomas, and 20 colloid goiters. PTC was characterized by a decreased expression of E-CAD and CD56 contrary to the surrounding benign thyroid tissues. There was no HBME-1 expression in benign thyroid tissues, but it was high in papillary thyroid carcinomas and weak in follicular adenomas. The expression of E-CAD and CD56 was significantly higher in follicular adenomas than in the surrounding thyroid tissues. Analyzing the FNA material, HBME-1 expression was documented in 96% of papillary thyroid carcinomas, but there was no expression in the benign lesions. E-CAD and CD56 expression was significantly weakened in papillary thyroid carcinomas, but enhanced in follicular adenomas. HBME-1 was found only in malignant lesions and can be considered the most sensitive, specific single marker in papillary thyroid carcinomas. CD56 and E-CAD can assist in the decision-making on the benign and malignant nature of the nodule. Immunocytochemistry is of value as an ancillary test to enhance the diagnostic accuracy of thyroid FNA samples.
Highlights
Thyroid nodules are a very frequent finding, and their prevalence steadily increases with age
CD56 and E-CAD can assist in the decision-making on the benign and malignant nature of the nodule
We evaluated the usefulness of applying the panel of 3 IHC markers – HBME-1, E‐cadherin (E-CAD) and CD56 – on the histological samples of various thyroid lesions as well as on thyroid fine needle aspiration (FNA) samples to determine their diagnostic accuracy in the differential diagnosis of thyroid nodules
Summary
Thyroid nodules are a very frequent finding, and their prevalence steadily increases with age. Nodular thyroid disease refers to the presence of a solid nodule, a multinodular gland, or one or more cystic lesions. Most of the discovered nodules are benign; there were approximately 44 000 estimated new cases of thyroid cancer and 1700 estimated deaths in the United States in 2010 [3]. The annual incidence increased from 3.6 per 100 000 in 1973 to 8.7 per 100 000 in 2002 (2.4-fold increase), and this trend appears to be continuing. It is caused by an increase in the incidence of papillary thyroid carcinoma (PTC), which increased from 2.7 to 7.7 per
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