Role of Immunohistochemistry in Fine Needle Aspiration and Core Needle Biopsy of Thyroid Nodules

Song, Seulki; Kim, Hyojin; Ahn, Sang‐Hyeon

doi:10.21053/ceo.2018.01011

Cited by 16 publications

(9 citation statements)

References 16 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We searched papers published in English in PubMed and found only one focusing on this topic. In this paper, Song et al reported that the continued indeterminate rate was 42.9% for FNB and 11.3% for CNB after IHC was applied[14]. In our study, all 72 indeterminate samples of CNB could be determined with the help of IHC, although the accuracy of each marker was different.…”

mentioning

confidence: 57%

Value of biomarkers in distinguishing indeterminate core needle biopsy samples of thyroid nodules

Xiong

Yan

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Core needle biopsy (CNB) is now more frequently used for the preoperative diagnosis of thyroid nodules. Based on morphology alone, 5%-20% of CNB samples cannot be determined as malignant or benign. Compared to fine-needle biopsy (FNB), samples collected by CNB are more accessible for various tests. Therefore, studying the application of biomarkers in distinguishing indeterminate CNB samples of thyroid nodules is a practical need. Methods: Patients with thyroid nodules with both CNB and matched resected specimens were reviewed. Cases classified as indeterminate lesions, follicular neoplasms and suspicious for malignancy were retrieved. All CNB samples were stained by immunohistochemistry (IHC) using antibodies against CK19, Galectin-3, HBME-1, and CD56 and detected by next-generation sequencing (NGS) using a target panel. With the help of these biomarkers, all CNB samples were reclassified. Taking the classification of resected specimens as the gold standard, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of each biomarker for discriminating malignancy from benignity were calculated. Results: The sensitivity, specificity, PPV, NPV and accuracy were 93.55%, 60.00%, 93.55%, 60.00% and 88.89% for CK19; 93.55%, 40.00%, 90.63%, 50.00% and 86.11% for Galectin-3; 77.42%, 100.00%, 100.00%, 41.67% and 80.56% for HBME-1; 66.13%, 100.00%, 100.00%, 32.26% and 70.83% for CD56; and 91.94%, 100.00%, 100.00%, 66.67% and 93.06% for pathogenic mutation. Conclusions: The application of biomarkers is very effective in distinguishing indeterminate CNB samples of thyroid nodules. Gene testing by NGS using a target panel has very high accuracy. The limitation of tumor quantity is the main reason for the weakened power of NGS. IHC plays an important role in cases with negative NGS results. The combination of NGS and IHC is a reliable “rule in” test for malignancy.

show abstract

mentioning

confidence: 57%

Value of biomarkers in distinguishing indeterminate core needle biopsy samples of thyroid nodules

Xiong

Yan

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…We searched papers published in English in PubMed and found only one focusing on this topic. In this paper, Song et al reported that the continued uncertain rate was 42.9% for FNB and 11.3% for CNB after IHC was applied [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Application of biomarkers in the diagnosis of uncertain samples of core needle biopsy of thyroid nodules

Xiong

Liang

et al. 2021

Virchows Arch

View full text Add to dashboard Cite

Core needle biopsy (CNB) is now more frequently used for the preoperative diagnosis of thyroid nodules. Based on morphology alone, 5–20% of CNB samples cannot be determined as malignant or benign. Compared to fine-needle biopsy (FNB), samples collected by CNB are more accessible for various tests. Therefore, studying biomarkers’ application in distinguishing uncertain CNB samples of thyroid nodules is a practical need. Patients of thyroid nodules with both CNB and matched resected specimens were reviewed. Cases classified as indeterminate lesions, follicular neoplasms, and suspicious for malignancy were retrieved. All CNB samples were stained by immunohistochemistry (IHC) using antibodies against CK19, galectin-3, HBME-1, and CD56 and detected by next-generation sequencing (NGS) using an OncoAim® thyroid cancer multigene assay kit (Singlera Genomics) that detected 26 genes. Taking the resected specimens’ classification as the gold standard, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy of a single biomarker, and various combinations for discriminating malignancy from benignity were calculated. The sensitivity, specificity, PPV, NPV, and accuracy for preoperative malignancy evaluation were as follows. In the cohort of non-follicular-neoplasm-lesions (non-FN-lesion), they were 95.16%, 53.85%, 90.77%, 70.00%, and 88.00% for CK19; 95.16%, 38.46%, 88.06%, 62.50%, and 85.33% for galectin-3; 77.42%, 76.92%, 94.12%, 41.67%, and 58.00% for HBME-1; 66.13%, 100.00%, 100.00%, 38.24%, and 72.00% for CD56; 90.32%, 92.31%, 98.25%, 66.67%, and 90.67% for NGS; and 88.71%, 92.30%, 98.21%, 63.16%, and 89.33% for integrated IHC. In the cohort of follicular neoplasms (FN), they were 30.43%, 77.77%, 77.77%, 30.43%, and 43.75% for CK19; 73.91%, 66.67%, 85.00%, 50.00%, and 71.88% for galectin-3; 26.09%, 88.89%, 85.71%, 32.00%, and 43.75% for HBME-1; 26.09%, 100.00%, 100.00%, 34.62%, and 46.88% for CD56; 52.17%, 88.89%, 92.31%, 42.11%, and 62.50% for NGS; 82.61%, 66.67%, 86.36%, 60.00%, and 78.13% for integrated IHC; and 100%, 66.67%, 88.46%, 100%, and 90.63% for integrated IHC-NGS. The application of biomarkers in distinguishing uncertain CNB samples of thyroid nodules is available and capable. CD56 negative or NGS positive suggests malignancy strongly for both FN and non-FN-lesion, which may be used as a “rule in” tool. The negative predictive value of the integrated IHC and the integrated IHC-NGS implies a high possibility to be benign for non-FN-lesion and FN separately, which can work as a “rule out” tool. Considering the balance of specificity and sensitivity, NGS is the best for non-FN-lesion and the integrated IHC-NGS is the best for FN.

show abstract

“…Furthermore, the association of additional markers (eg, galectin-3) can improve its Sn to 94%, with a high negative predictive value (92%) retaining moderate Sp and positive predictive value (73% and 50%, respectively). This can be of help to rule out follicular carcinoma in cytology when both are negative 26 27…”

Section: Introduction and Historical Perspectivementioning

confidence: 99%

Lights on HBME-1: the elusive biomarker in thyroid cancer pathology

et al. 2022

View full text Add to dashboard Cite

Among the different ancillary immunohistochemical tools that pathologists may employ in thyroid nodules, the so-called Hector Battifora’s ‘MEsothelioma’ 1 (HBME-1) staining is one of the most fascinating, since its real identity is currently unknown. In the present review, the different clinical applications of HBME-1 are analysed, with main emphasis on its role in thyroid pathology with overview on less impactful fields, such as haematopathology or mesothelial lesions. Different acceptable or good diagnostic performances were recorded for HBME-1 in thyroid pathology, being used in routine practice as one of the best tools to screen thyroid malignancy both in terms of sensitivity and specificity. From a speculative point of view, after many attempts to hunt the cryptic target antigen of this antibody, its identity still remains elusive. In this setting, the application of high-throughput technologies (mainly in situ proteomics) may be the exact route to improve the knowledge about the pathophysiology of HBME-1 and to finally unveil its true identity.

show abstract

Role of Immunohistochemistry in Fine Needle Aspiration and Core Needle Biopsy of Thyroid Nodules

Cited by 16 publications

References 16 publications

Value of biomarkers in distinguishing indeterminate core needle biopsy samples of thyroid nodules

Value of biomarkers in distinguishing indeterminate core needle biopsy samples of thyroid nodules

Application of biomarkers in the diagnosis of uncertain samples of core needle biopsy of thyroid nodules

Lights on HBME-1: the elusive biomarker in thyroid cancer pathology

Contact Info

Product

Resources

About