Follicular thyroid neoplasms can be classified as low- and high-risk according to HBME-1 and Galectin-3 expression on liquid-based fine-needle cytology
Follicular thyroid neoplasms can be classified as low- and high-risk according to HBME-1 and Galectin-3 expression on liquid-based fine-needle cytology
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DOI：
10.1530/eje-11-0181
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发表时间：
2011-09-01
影响因子：
5.8
通讯作者：
Rindi, Guido
中科院分区：
文献类型：
--
作者：
Fadda, Guido;Rossi, Esther Diana;Rindi, Guido
设计：细针穿刺活检（FNAB）是诊断甲状腺结节最可靠的诊断工具。滤泡性肿瘤伴不典型细胞的细胞学诊断意义不明（FN/AUS）意味着在手术和随访之间选择患者是困难的。在这种情况下，免疫细胞化学染色可能会有所帮助。方法：从7091例经液基细胞学（LBC）处理的甲状腺细针穿刺标本中，选择120例手术患者，用HBME-1和Galectin-3抗体联合检测。这些病例被分类为良性病变（BL，8例）、FN，包括Bethesda分类的ACUS类别（FN/AUS，50例）、疑似恶性肿瘤（SM，59例）和恶性肿瘤（MN，3例）。结果：所有MN和BL均经病理证实。FN/AUS和SM的恶性风险分别为24%和72.9%。完整的免疫细胞化学面板是阳性的情况下，在恶性肿瘤和阴性的情况下，在良性组织学的87.5%。在FN/AUS中，76.9%的恶性病例免疫细胞化学完全阳性，96.8%的良性病例免疫细胞化学完全阴性。HBME-1和半乳糖凝集素-3在分类为FN/AUS的病例中的表达可有效区分病变，需要立即手术的患者（高风险或FNH或Thy 3 h）与可以随访的患者（低风险或FNL或Thy 3l）。
Design: Fine-needle aspiration biopsy (FNAB) is the most reliable diagnostic tool in the diagnosis of thyroid nodules. A cytologic diagnosis of follicular neoplasm with atypical cells of undetermined significance (FN/AUS) implies that the selection of patients between surgery and follow-up is difficult. In this setting immunocytochemical stainings might be helpful. The efficacy of a panel made up of HBME-1 and Galectin-3 antibodies is evaluated in cases processed by liquid-based cytology (LBC).Methods: Out of 7091 thyroid FNAB processed by LBC method, 120 cases undergoing surgery successively were selected. These cases were classified as benign lesion (BL, eight cases), FN, including the ACUS category of the Bethesda classification (FN/AUS, 50 cases), suspicious for malignancy (SM, 59 cases), and malignant neoplasm (MN, three cases). Immunostains for HBME-1 and Galectin-3 were carried out on the LBC slides.Results: All MN and BL were histologically confirmed. FN/AUS and SM showed a malignancy risk of 24 and 72.9% respectively. The complete immunocytochemical panel was positive in 83.3% of the cases resulting in malignancy and negative in 87.5% of cases resulting in benign histology. Among the FN/AUS, the complete positive immunocytochemical panel was detected in 76.9% of cases resulting as malignant and the complete negative immunocytochemical panel was observed in 96.8% of cases resulting as benign at histology.Conclusions: The expression of HBME-1 and Galectin-3 in cases classified as FN/AUS on LBC-processed FNABs can effectively distinguish lesions, which need immediate surgery (high risk or FNH or Thy 3h) from those which can be followed-up (low risk or FNL or Thy 3l).