Papotti Mauro, Rodriguez Jaime, De Pompa Roberta, Bartolazzi Armando, Rosai Juan
Department of Clinical and Biological Sciences, University of Turin and St Luigi Hospital, Orbassano, Turin, Italy.
Mod Pathol. 2005 Apr;18(4):541-6. doi: 10.1038/modpathol.3800321.
Well-differentiated encapsulated tumors of the thyroid gland with a follicular architecture may cause diagnostic difficulties. Questionable vascular or capsular penetration may raise the possibility of a follicular carcinoma, while focal nuclear clearing and grooves may suggest a diagnosis of papillary carcinoma. A proposal has recently been made to designate cases showing suggestive but not conclusive morphological evidence of malignancy along these lines as well-differentiated or follicular tumors of uncertain malignant potential. The aim of the present study was to investigate the expression and diagnostic role in well-differentiated or follicular tumors of uncertain malignant potential of Galectin-3 and HBME-1, two malignancy-related markers. A total of 21 tumors fulfilling the criteria of well-differentiated or follicular tumors of uncertain malignant potential were collected from two institutions, including eight cases with questionable vascular and/or capsular invasion and 13 cases with some degree of nuclear changes in the form of clearing, grooves, and/or pseudoinclusions. Tumors in the first group expressed HBME-1 and Galectin-3 focally (less than 25% of tumor cells) in 5/8 and 3/8 cases, respectively, with 62.5% of cases reacting for at least one marker. Cases in the second category expressed HBME-1 and Galectin-3 in 9/13 and 10/13 cases, respectively, with 92.3% of cases having at least one marker expressed. These findings indicate that HBME-1 and Galectin-3 are heterogeneously distributed in these borderline tumors, but that a strong and diffuse expression of HBME-1 and to a lower extent of Galectin-3 was preferentially observed in the group characterized by nuclear changes which were similar but less developed than those of conventional papillary carcinoma. The relationship found between the markers investigated and these nuclear changes suggests that the tumors containing them are pathogenetically linked to papillary carcinomas.
具有滤泡状结构的甲状腺高分化包膜肿瘤可能会导致诊断困难。可疑的血管或包膜侵犯可能增加滤泡癌的可能性，而局灶性核空晕和核沟可能提示乳头状癌的诊断。最近有人提议将那些显示出沿着这些线索提示恶性但并非确凿形态学证据的病例指定为恶性潜能不确定的高分化或滤泡性肿瘤。本研究的目的是调查两种与恶性相关的标志物Galectin-3和HBME-1在恶性潜能不确定的高分化或滤泡性肿瘤中的表达及诊断作用。从两个机构收集了总共21例符合恶性潜能不确定的高分化或滤泡性肿瘤标准的肿瘤，包括8例有可疑血管和/或包膜侵犯的病例以及13例有某种程度核改变（以核空晕、核沟和/或假包涵体形式）的病例。第一组肿瘤中，分别有5/8和3/8的病例HBME-1和Galectin-3呈局灶性表达（少于25%的肿瘤细胞），62.5%的病例对至少一种标志物有反应。第二类病例中，分别有9/13和10/13的病例表达HBME-1和Galectin-3，92.3%的病例至少有一种标志物表达。这些发现表明，HBME-1和Galectin-3在这些临界肿瘤中呈异质性分布，但在以核改变为特征的组中，优先观察到HBME-1的强而弥漫性表达，Galectin-3的表达程度较低，这些核改变与传统乳头状癌相似但程度较轻。所研究的标志物与这些核改变之间的关系表明，含有它们的肿瘤在发病机制上与乳头状癌有关。
