Divisions of Anatomic Pathology and Histology Endocrinology Endocrine Surgery, Agostino Gemelli School of Medicine, Catholic University of Sacred Heart, Largo Francesco Vito, 1 - 00168 Rome, Italy.
Eur J Endocrinol. 2011 Sep;165(3):447-53. doi: 10.1530/EJE-11-0181. Epub 2011 Jul 1.
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).
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.
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.
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).
细针穿刺活检（FNAB）是诊断甲状腺结节最可靠的诊断工具。细胞学诊断为滤泡性肿瘤伴意义未明的不典型细胞（FN/AUS）意味着手术和随访之间的患者选择困难。在这种情况下，免疫细胞化学染色可能会有所帮助。评估了由 HBME-1 和半乳糖凝集素-3 抗体组成的抗体组合在经液体基础细胞学（LBC）处理的病例中的功效。
在 LBC 方法处理的 7091 例甲状腺 FNAB 中，选择了 120 例连续手术的病例。这些病例分为良性病变（BL，8 例）、FN（包括 Bethesda 分类的 ACUS 类别）、可疑恶性（SM，59 例）和恶性肿瘤（MN，3 例）。对 LBC 载玻片上的 HBME-1 和半乳糖凝集素-3 进行免疫染色。
所有 MN 和 BL 均经组织学证实。FN/AUS 和 SM 的恶性风险分别为 24%和 72.9%。完全免疫细胞化学检测阳性的病例中 83.3%为恶性，完全阴性的病例中 87.5%为良性组织学。在 FN/AUS 中，完全阳性的免疫细胞化学检测在 76.9%的恶性病例中检测到，而在 96.8%的良性组织学病例中检测到完全阴性的免疫细胞化学检测。
在 LBC 处理的 FNAB 中分类为 FN/AUS 的病例中 HBME-1 和半乳糖凝集素-3 的表达可以有效地区分需要立即手术（高风险或 FNH 或 Thy 3h）的病变与可以随访（低风险或 FNL 或 Thy 3l）的病变。
