Immunocytochemical evaluation of thyroid neoplasms on thin-layer smears from fine-needle aspiration biopsies

Abstract

BACKGROUND Fine‐needle aspiration biopsy (FNAB) is the most reliable diagnostic tool for thyroid nodules. A difficult cytologic diagnosis may be supported by an immunocytochemical study. The efficacy of a panel made up of RET, HBME‐1, and Galectin‐3 antibodies was evaluated in smears processed by thin‐layer cytology (TLC). DESIGN Thyroid FNABs (n = 99) with both conventional (CS) and thin‐layer cytology (TLC) smears were studied. The cases were diagnosed as follows: 5 benign lesions (BL), 13 papillary carcinomas (PC), and 81 follicular proliferations (FP). The category of FP was divided into three subgroups according to nuclear features of follicular cells: Follicular neoplasm (FN NOS), oxyphilic follicular neoplasm (OFN), and folliucular lesion with nuclear pleomorphism (FLWNP). Immunostains for HBME‐1, Galectin‐3, and RET were carried out on TLC slides. RESULTS Among 49 cases undergoing surgery, all 10 PC and 2 BL were histologically confirmed, whereas 15 out of 37 FP (40.5%) were malignant. The complete immunocytochemical panel (ICCP) was positive in 9 of 10 malignancies (90%) and negative in both BLs. Out of 37 FP, the ICCP yielded positive in 15 cases (4 benign, 11 malignant) and negative in 11 (all benign). In the FLWNP subgroup, the ICCP was positive in 11 (84.6%) and negative in 2 histologically benign cases. CONCLUSION The combined panel of antibodies and the nuclear pleomorphism of follicular cells were effective in distinguishing between thyroid nodules requiring surgery from thyroid nodules requiring just follow‐up. Cancer (Cancer Cytopathol) 2005. © 2005 American Cancer Society.

Utility of malignancy markers in fine-needle aspiration cytology of thyroid nodules: comparison of Hector Battifora mesothelial antigen-1, thyroid peroxidase and dipeptidyl aminopeptidase IV

“…In our experience, thyroid FNA stored at À201C for more than 10 years retained their morphology and immunostaining properties for all the investigated antigens (thyroglobulin, thyrocalcitonin, thyroid transcription factor 1, TPO, and HBME-1), provided that they were performed and frozen immediately after resection. As our results of HBME ICC on FNAC obtained on resected nodule are very similar to those previously reported on FNAC obtained percutaneously (Sack et al, 1997;Rossi et al, 2005), it is reasonable to assume that these differences in FNA sampling methods had no significant influence on ICC.…”

“…To our knowledge, all but two previous studies of HBME on thyroid FNA (Sack et al, 1997;Rossi et al, 2005) were carried out on cell blocks (van Hoeven et al, 1998;Saggiorato et al, 2005). However, overall results obtained on fresh tissue, including our study, and cell blocks are rather concordant.…”

“…However, overall results obtained on fresh tissue, including our study, and cell blocks are rather concordant. The sensitivity of HBME-1 staining was excellent (490%) for classical PC (van Hoeven et al, 1998;Ito et al, 2005;Rossi et al, 2005), disappointing for PCFV, and poor (o65%) for follicular and undifferentiated cancers (Cheung et al, 2001;Mai et al, 2002;Ito et al, 2005;Prasad et al, 2005;Saggiorato et al, 2005). The reported specificity of HBME-1 staining ranged from 70% to more than 90% (Cheung et al, 2001;Prasad et al, 2005;Saggiorato et al, 2005).…”

“…Molecular methods such as mutation detection or expression profile analysis are promising but cannot currently be used for routine practice (Eszlinger et al, 2006;Griffith et al, 2006;Lubitz et al, 2006;Tetzlaff et al, 2006;Finn et al, 2007). On the contrary, immunocytochemistry (ICC) and cytoenzymology (CE) are widely available and can be performed on smears (De Micco et al, 1994a), cell blocks (Sack et al, 1997), or liquid-based preparation (Rossi et al, 2005). Out of several markers that have been investigated, the most attractive for diagnosis on thyroid FNA are Hector Battifora mesothelial antigen-1 (HBME-1), thyroid peroxidase (TPO), and dipeptidyl aminopeptidase IV (DPP4) because they can be used directly on smears.…”

“…Most studies using HBME-1 for diagnosis of thyroid tumours have been performed on tissue samples (Mai et al, 2002;Ito et al, 2005;Papotti et al, 2005;Prasad et al, 2005). A few studies using FNA products have been carried out on cell blocks or thin layers (Sack et al, 1997;van Hoeven et al, 1998;Rossi et al, 2005;Saggiorato et al, 2005). We have developed an HBME-1 staining technique for air-dried thyroid FNA smears.…”