HBME-1 immunostaining in thyroid fine-needle aspirations: a useful marker in the diagnosis of carcinoma.
HBME-1 immunostaining in thyroid fine-needle aspirations: a useful marker in the diagnosis of carcinoma.
复制标题
甲状腺细针抽吸中的 HBME-1 免疫染色：诊断癌症的有用标记。
作者：
Martha J. Sack;C. Astengo;B. T. Lin;Hector Battifora;Virginia A. LiVolsi
针对间皮细胞微绒毛表面产生的单克隆抗体HBME-1已被证明在滤泡源性甲状腺恶性肿瘤的组织切片中具有显著的反应性。我们研究了HBME-1在甲状腺细针穿刺（FNA）标本中的诊断效用。对23例患者的24份抽吸物进行了评价。仅研究了具有足够细胞块和组织随访的病例。采用标准抗生物素蛋白-生物素过氧化物酶复合物法和表位修复法，对风干直接涂片和布因固定石蜡包埋细胞块切片进行免疫细胞化学分析。将相同的免疫染色技术应用于相应的福尔马林固定的组织切片。14例恶性抽吸物中有8例（57%）表现出HBME-1的强细胞质和/或细胞膜免疫反应性。细胞块和直接涂片制备阳性的7乳头状癌（一个滤泡变体），一个微创滤泡癌，四个混合乳头状和滤泡特征的混合肿瘤之一。另一例杂交瘤病例仅在涂片载玻片中呈局灶性阳性。第8例阳性病例为喉腺鳞状细胞癌，侵入甲状腺（该病例的涂片制备为阴性）。10例良性病变均为阴性。所有恶性肿瘤组织切片均呈HBME-1阳性，10例良性切除标本中有5例呈局灶性阳性。我们的结论是HBME-1的甲状腺细针穿刺活检阳性是支持病变是癌的证据，HBME-1的阴性结果并不排除甲状腺癌的诊断，HBME-1可以有效地应用于甲状腺细针穿刺活检标本，可以是一个有价值的辅助甲状腺恶性肿瘤的细胞学诊断。
The monoclonal antibody, HBME-1, generated against the microvillous surface of mesothelial cells, has been shown to have significant reactivity in histologic sections of follicular-derived thyroid malignancies. We examined the diagnostic utility of HBME-1 in thyroid fine-needle aspiration (FNA) specimens. Twenty-four aspirates from 23 patients were evaluated. Only cases with adequate cell blocks and tissue follow-up were studied. Immunocytochemical analysis was performed on air-dried, direct smears and on sections from Bouin's-fixed, paraffin-embedded cell blocks with a standard avidin-biotin peroxidase complex method with epitope retrieval. The same immunostaining technique was applied to the corresponding formalin-fixed tissue sections. Eight (57%) of the 14 malignant aspirates showed strong cytoplasmic and/or membrane immunoreactivity for HBME-1. The cell-block and direct-smear preparations were positive in five of seven papillary carcinomas (one follicular variant), one of one minimally invasive follicular carcinoma, and one of four hybrid tumors with mixed papillary and follicular features. An additional hybrid tumor case was focally positive only in the smear slide. The eighth positive case was an adenosquamous carcinoma of the larynx that invaded into the thyroid (smear preparation was negative for this case). The 10 benign lesions were negative. All of the malignant-tumor tissue sections were positive for HBME-1, and focal positivity was seen in 5 of 10 benign resection specimens. We conclude that a positive immunostain for HBME-1 on a thyroid FNA is supportive evidence that the lesion is a carcinoma, that a negative result for HBME-1 does not preclude the diagnosis of thyroid carcinoma, and that HBME-1 can be effectively applied to thyroid FNA specimens and can be a valuable adjunct in the cytologic diagnosis of thyroid malignancies.