Large needle aspiration biopsy and galectin-3 determination in selected thyroid nodules with indeterminate FNA-cytology

Abstract

Thyroid fine-needle aspiration biopsy (FNA)-cytology is widely used for the preoperative characterisation of thyroid nodules but this task is difficult for follicular lesions, which often remain undefined. We propose a strategy for improving the preoperative characterisation of selected follicular thyroid proliferations, which is based on large needle aspiration biopsy (LNAB) and galectin-3 expression analysis. Eighty-five thyroid specimens were obtained by LNAB (20-gauge needles) from thyroid nodules with indeterminate follicular FNA-cytology. Aspirated material was processed as a tissue microbiopsy to obtain cell blocks for both cyto/ histo-morphological evaluation and galectin-3 expression analysis, by using a purified monoclonal antibody to galectin-3 and a biotinfree immunoperoxidase staining method. Preoperative diagnosis was compared to the final histology. LNAB and cell-block technique allow a preliminary distinction between nodules with a homogeneous microfollicular/trabecular structure, as frequently observed in tumours, and lesions with mixed normo -micro -macrofollicular architecture, as observed in goitre. Furthermore, LNAB provides optimal substrates for galectin-3 expression analysis. Among 85 cases tested, 14 galectin-3-positive cases were discovered preoperatively (11 thyroid cancers and three adenomas confirmed at the final histology), whereas galectin-3-negative cases were 71 (one carcinoma and 70 benign proliferations at the final histology). Sensitivity, specificity and diagnostic accuracy of this integrated morphologic and phenotypic diagnostic approach were 91.6, 97.2 and 95.3%, respectively. In conclusion, LNAB plus galectin-3 expression analysis when applied preoperatively to selected thyroid nodules candidate to surgery can potentially reduce unnecessary thyroid resections.

Involvement of decreased Galectin‐3 expression in the pathogenesis and progression of prostate cancer

“…Therefore, Gal-3 protein might be an additional and valuable molecular tool not only to augment the diagnosis of malignant intra-prostatic disease but to also determine the biological activity with regard to the intra-cellular localization of the protein [5]. The observation that already benign glands in the neighborhood of the primary solid tumors as well as PIN lesions tissues exhibit a staining pattern that is substantially different from that in prostate specimens obtained from patients with benign prostatic disease might help to differentiate more precisely between benign and malignant biopsies as supposed for small needle biopsies from thyroid cancer [20][21][22].…”

99mTc-MIBI Imaging in the Presurgical Characterization of Thyroid Follicular Neoplasms: Relationship to Multidrug Resistance Protein Expression

“…Although immunocytochemical evaluation of some tumorassociated antigens, such as galectin-3 (7)(8)(9)(10)(11)(12)(13)(14), cell surface mesothelial antigen HBME-1 (8,(14)(15)(16)(17), and cytokeratin-19 (8,16,17), was recently successfully introduced for the thyroid to improve preoperative cytologic diagnosis, the issue of follicular neoplasm remains incompletely solved and these lesions still need surgical procedures for a definitive diagnosis.…”

Expression of ARE-binding proteins AUF1 and HuR in follicular adenoma and carcinoma of thyroid gland

“…Previous studies demonstrated that optimal staining with galectin-3, broadly reported as thyroid biomarker, requires formalin-fixed and paraffin-embedded preparations, biotin-free detection systems and application of specific monoclonal antibodies. Additionally, the conventional thyroid smears were reported to be inadequate for galectin-3 purposes [29], but its diagnostic properties are excellent on large-needle aspiration biopsy (LNAB) derived substrates [44]. Also the other markers including human mesothelial antigen (HBME-1), cytokeratin 19 (CK19), thyroid peroxidase (TPO) and keratan-sulphate (KS) or proteins related with energy metabolism such as alpha enolase (ENO1), glyceraldehyde-3-phosphate dehydrogenase (GAPDH), pyruvate kinase isoenzymes M1/M2 (PKM1/ M2) and transketolase (TKT) employed to surgical thyroid or FNAB samples were reported to possess the diagnostic potential [45,22].…”