HBME-1 immunostaining in thyroid tumors especially in follicular neoplasm
HBME-1 immunostaining in thyroid tumors especially in follicular neoplasm
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DOI：
10.1507/endocrj.50.173
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发表时间：
2003-04-01
影响因子：
2
通讯作者：
Nakao, A
中科院分区：
文献类型：
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作者：
Mase, T;Funahashi, H;Nakao, A
众所周知，即使是永久性切片，滤泡性腺瘤和滤泡性癌之间的鉴别诊断通常也很难确定。被诊断为良性滤泡性腺瘤的患者由于复发或转移而不得不将诊断改为恶性肿瘤的情况并不少见。由于间皮瘤细胞产生的单抗HBME-1已被证明在甲状腺癌中具有反应性，我们研究了HBME-1在滤泡性肿瘤诊断中的作用。应用免疫组织化学S-P法对205例甲状腺肿瘤组织进行HBME-1免疫组织化学染色。再次行苏木精-伊红(HE)染色，所有病例均按WHO第二版组织学分类，87.2%(54/62)的腺瘤性甲状腺肿和72.6%(45/62)的滤泡性腺瘤为阴性。滤泡性癌阳性率为84.6%(33/39)，乳头状癌阳性率为97.2%(35/36)。未分化癌(2/2)和髓样癌(4/4)均为阴性。滤泡性肿瘤的敏感性为84.6%，特异性为72.6%，阳性预测值为66.0%，总的准确性为77.2%。在临床诊断为滤泡性腺瘤的病例中，13例诊断为滤泡性癌，6例诊断为乳头状癌。这些病例HBME-1呈强阳性。其中2例滤泡性癌复发。我们的结论是，HBME-1免疫组织化学染色可能有助于临床筛选滤泡性癌复发风险较高的病例，而良性腺瘤病例需要密切随访。
It is generally known that even with permanent sections, the differential diagnosis between follicular adenoma and follicular carcinoma is often difficult to determine. It is not unusual to encounter patients diagnosed with benign follicular adenoma whose diagnoses have to be changed to malignancies because of recurrence or metastasis. As the monoclonal antibody HBME-1 produced by mesothelioma cells has been shown to have reactivity in thyroid carcinomas, we investigated the diagnostic usefulness of HBME-1 in follicular neoplasms. Immunohistochemical staining for HBME-1 was performed on 205 various thyroid tumors using the labeled streptavadin biotin peroxidase method. When hematoxylin-eosin (HE) staining was performed again for this study and all cases were examined in accordance with the WHO Histological Classifications 2nd Edition, 87.2% (54/62) of adenomatous goiter and 72.6% (45/62) of follicular adenoma were negative. On the other hand, 84.6% (33/39) of follicular carcinoma and 97.2% (35/36) of papillary carcinoma were positive. All anaplastic (2/2) and medullary (4/4) carcinoma were negative. Examination in follicular neoplasms had a sensitivity of 84.6%, specificity of 72.6%, positive predictive value of 66.0% and overall accuracy of 77.2%. Among the cases treated as follicular adenoma clinically, the diagnosis of 13 cases was changed to follicular carcinoma, and 6 cases to papillary carcinoma for this study. These cases showed strong HBME-1 positivity. Two of the follicular carcinoma cases experienced recurrence. We conclude that immunohistochemical staining with HBME-1 may be useful clinically to pick out cases with a high risk of recurrence in follicular carcinoma, and that benign adenoma cases need close follow-up.