The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology

Cha, Hyunseo; Pyo, Jung Yoon; Hong, Soon Won

doi:10.4132/jptm.2018.09.20

Cited by 10 publications

(7 citation statements)

References 38 publications

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“…The overall accuracy of 91.2% in that study is comparable to the 100% accuracy of the current study [15]. A similar study performed in Korea to evaluate the usefulness of the CD-56 marker revealed that it has greater sensitivity and that combined use with the HBME-1 biomarker can increase the speci city [15]. Consistent with the ndings of the present study, George et al (2017) reported that the sensitivity and speci city of FNAC can increase by up to 98.88% and 99.11%, respectively, when immunocytomarkers are used [16].…”

Section: Discussionsupporting

confidence: 78%

“…The current study ndings showed 100% concordance in immunocytochemistry and histology results, indicating the higher diagnostic speci city and malignant predictability of the immunocytochemistry technique. The overall accuracy of 91.2% in that study is comparable to the 100% accuracy of the current study [15]. A similar study performed in Korea to evaluate the usefulness of the CD-56 marker revealed that it has greater sensitivity and that combined use with the HBME-1 biomarker can increase the speci city [15].…”

Section: Discussionsupporting

confidence: 71%

See 1 more Smart Citation

Pre-Operative Diagnosis of Suspicious Thyroid Nodules: An Integrated Multidisciplinary Approach

Kulatunga,

Pathirana,

Fernando

et al. 2024

Preprint

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Background Despite the increase in thyroid tumor incidence, the malignancy rate is low. This increased incidence poses a substantial burden on the healthcare system. The costs associated with surgery and limited theater facilities restrict addressing of all thyroid tumors surgically. Effective modes of preoperative diagnosis are essential for efficient disease prognosis and treatment. Unnecessary surgeries on benign nodules and completion thyroidectomies are reported due to inaccuracies of preoperative diagnostic methods. Therefore, this study aimed to compare the efficacy of preoperative diagnostic methods such as the Thyroid Imaging Reporting and Data System (TIRADS), Bethesda classification, and immunocytochemistry in predicting malignancy. Methods A descriptive cross-sectional study was conducted enrolling 106 radiologically malignancy-suspected patients. TIRADS for Ultrasound scan and Bethesda classification for fine needle aspiration cytology (FNAC) reporting were used. Immunocytochemistry was performed using a panel of immune markers consisting of CD-56, HBME-1, and CK-19. All patients were followed up for 2 years. The results were analysed using R version 4.3.1. Results The majority of the participants were females (n = 84, 79.2%). The ages ranged from 15–76 years (47.20 ± 12.90). Significant associations were observed between the TIRADS classification and Bethesda classification (p = 0.00009). Additionally, significant associations were observed between TIRADS (p = 0.046), Bethesda (p = 0.00143), immunocytochemistry (p = 0.0000), and malignant status of the patients at follow-up. The combined use of the Bethesda system and TIRADS significantly improved the malignant predictability of patients. Immunocytochemistry showed 100% concordance with patient status at follow-up. Conclusion The effectiveness of preoperative diagnosis of thyroid tumors can be increased by the combined use of preoperative techniques such as the TIRADS classification system and the Bethesda system. Immunocytochemistry can be used as a stand-alone technique to predict the malignancy of thyroid nodules.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 71%

Pre-Operative Diagnosis of Suspicious Thyroid Nodules: An Integrated Multidisciplinary Approach

Kulatunga,

Pathirana,

Fernando

et al. 2024

Preprint

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“…In a recent study, researchers demonstrated that CD56 is a handy screening marker in thyroid cytology. CD56 showed high sensitivity (90%) and diagnostic accuracy (88.4%) in the diagnosis of the indeterminate lesion (Bethesda category III) 29. Although the overall diagnostic performance of CD56 is good,16 our results reveal the possible pitfall when using CD56 for preoperative diagnosis.…”

Section: Discussionmentioning

confidence: 68%

“…CD56 showed high sensitivity (90%) and diagnostic accuracy (88.4%) in the diagnosis of the indeterminate lesion (Bethesda category III). 29 Although the overall diagnostic performance of CD56 is good, 16 our results reveal the possible pitfall when using CD56 for preoperative diagnosis. Expression of CD56 in the tall cell variant, classic PTC with tall cell features, Warthin-like, or cribriformmorular PTCs will not cause misdiagnosis in the surgical specimen because the histologic characteristics of these variants are evident.…”

Section: Discussionmentioning

confidence: 78%

CD56 Expression in Papillary Thyroid Carcinoma Is Highly Dependent on the Histologic Subtype: A Potential Diagnostic Pitfall

Cho¹,

Kim

Jeon

et al. 2022

Applied Immunohistochemistry &Amp; Molecular Morphology

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Loss of CD56 expression has been regarded as a diagnostic marker of papillary thyroid carcinoma (PTC). However, certain variants of PTC can aberrantly express CD56. Using a digital image analysis tool, we evaluated H-scores of CD56 immunostaining in 216 thyroid tumors. The H-score of the CD56 of all PTCs was lower than that of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) (P<0.001). The H-scores of CD56 were lower in classic PTC, the infiltrative follicular variant, and the diffuse sclerosing variant than in other PTC variants (P<0.001), whereas the H-scores were higher in tall cell variant, Warthin-like variant, and cribriform-morular variant than in classic PTC (P<0.001). The optimal cutoff value of H-scores for the CD56 expression was 180 for differentiating the NIFTP from the follicular adenoma and 30 for the differential diagnosis of NIFTP and infiltrative follicular variant PTC. CD56 expression is predominantly lost in classic and infiltrative follicular variants of PTCs and more preserved in the other histologic subtypes of PTC and NIFTP. CD56 is particularly useful for differentiating PTC from follicular-pattern thyroid neoplasms, but the aberrant expression in uncommon variants of PTC could be a diagnostic pitfall.

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“…[42] Β-catenin 100% sensitive in cribriform morula variant of papillary thyroid carcinoma [43] HBME-1, CD15 HBME-1 is a sensitive marker for both usual type of papillary carcinoma and follicular variant papillary thyroid carcinoma, Sensitivity is low and specificity is high in CD15 [44] CD79a, CD 03, CD 30, cytkeratin FNAC in combination with immunocytochemistry increases the diagnostic efficacy of thyroid lymphoma. [45] CD 147 CD147 expression correlates significantly with the degree of dedifferentiation of thyroid carcinoma [46] CD56, HBME-1 CD-56 has a low specificity with a high sensitivity. Combination of CD56 with HBME-1 increases the specificity.…”

Section: Research Immunocytochemical Markers Used Diagnosismentioning

confidence: 99%

Cell Block Preparation for Fine Needle Aspiration Cytology of Thyroid; Cost Effective Method in a Resource Poor Setting

Kulatunga¹,

Pathirana²,

Fernando³

et al. 2020

AJLM

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Over the past thirty years thyroid tumor incidence has triplicated and it is currently 7% of a given population. However, interestingly the thyroid cancer incidence is quite low and is approximately 5-10% of the thyroid tumor patients. Expeditious diagnosis of the thyroid nodules at the pre surgery stage is important to determine the tumor prognosis. A Widely used diagnostic approach is the direct observation of the fine needle aspiration specimens. However, using only this method many reported cases of unnecessary surgeries and re-operative incidents due to false diagnosis at the preoperative stage have been observed. Poor cellularity, loss of tissue architecture, poor cytomorphologic features in fine needle aspiration smears leads to incorrect diagnosis. Cell block technique is a better diagnostic approach at the pre-operative stage to overcome the pitfalls in direct smears as it concentrates the cells and preserve tissue architecture. Further, multiple sections with same cellularity can be prepared from a single cell block allowing the use for more advanced techniques like immunohistochemistry and molecular diagnosis. Cell block technique strengthen the diagnosis of tumors by fine needle aspiration specimens. Combined use of cell block technique with fine needle aspiration can reach to a sensitivity of about 95-100% suggesting that every FNAC specimen should be subjected to cell block preparation whenever possible.

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The Usefulness of Immunocytochemistry of CD56 in Determining Malignancy from Indeterminate Thyroid Fine-Needle Aspiration Cytology

Cited by 10 publications

References 38 publications

Pre-Operative Diagnosis of Suspicious Thyroid Nodules: An Integrated Multidisciplinary Approach

Pre-Operative Diagnosis of Suspicious Thyroid Nodules: An Integrated Multidisciplinary Approach

CD56 Expression in Papillary Thyroid Carcinoma Is Highly Dependent on the Histologic Subtype: A Potential Diagnostic Pitfall

Cell Block Preparation for Fine Needle Aspiration Cytology of Thyroid; Cost Effective Method in a Resource Poor Setting

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