Immunohistochemical Diagnosis of Papillary Thyroid Carcinoma

Abstract

In thyroid, the diagnosis of papillary carcinoma (PC) is based on nuclear features; however, identification of these features is inconsistent and controversial. Proposed markers of PC include HBME-1, specific cytokeratins (CK) such as CK19, and ret, the latter reflecting a ret/PTC rearrangement. We applied immunohistochemical stains to determine the diagnostic accuracy of these three markers. . HBME-1 and ret were negative in all NH and FA; some of these exhibited focal CK19 reactivity in areas of degeneration. Half of the FC and AC exhibited HBME-1 staining but no positivity for CK19 or ret. In PC, 20% of cases stained for all three markers. Classical PC had the highest positivity with staining for HBME-1 in 70%, CK19 in 80%, and ret in 78%. FVPC were positive for HBME-1 in 45%, for CK19 in 57%, and for ret in 63%; only 7 FVPC were negative for all three markers. The six IC exhibited 67% staining for HBME-1 and 50% positivity for CK19 and ret. The seven HCC had 29% positivity for HBME-1 and CK19, and 57% positivity for ret. This panel of three immunohistochemical markers provides a useful means of diagnosing PC. Focal CK19 staining may be found in benign lesions, but diffuse positivity is characteristic of PC. HBME-1 positivity indicates malignancy but not papillary differentiation. Only rarely are all three markers negative in PC; this panel therefore provides an objective and reproducible tool for the analysis of difficult thyroid nodules.

Galectin-3, fibronectin-1, CITED-1, HBME1 and cytokeratin-19 immunohistochemistry is useful for the differential diagnosis of thyroid tumors

“…The monoclonal antibody HBME1 was included for comparison because of its reported specificity for papillary thyroid carcinoma. [23][24][25] Our study shows that these proteins were not only expressed in papillary thyroid carcinomas but also in other follicular cell-derived thyroid carcinomas. Indeed, this relative lack of specificity for malignant tumors was very useful in differentiating all carcinomas from adenomas.…”

“…Several recent studies have reported HBME1 expression to be diagnostically useful in papillary thyroid carcinoma. 23,25 However, to the best of our knowledge, no single marker by itself is 100% sensitive for malignancy. By immunohistochemistry, ret/PTC and PPARg are reported in o70% of papillary and follicular thyroid carcinomas, respectively, while CD10 is expressed in follicular carcinoma and follicular variant of papillary carcinoma, but not in conventional papillary thyroid carcinoma.…”

“…KRT19 encodes cytokeratin-19 (CK19), a cytoskeletal protein that is significantly increased in papillary thyroid carcinoma, and has been reported to be helpful in distinguishing it from other benign and malignant thyroid nodules. 5,[19][20][21][22][23] HBME1, a monoclonal antibody generated against a suspension of malignant epithelial mesothelioma cells, reacts with the microvillous surface protein of mesothelial cells. We included HBME1 because its expression has been reported in papillary and follicular thyroid carcinoma but not in normal thyroid cells.…”

“…We included HBME1 because its expression has been reported in papillary and follicular thyroid carcinoma but not in normal thyroid cells. [23][24][25] …”

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

“…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).…”