Abulkheir Iman Loay Hussein, Mohammad Dalia Bilal
Department of Pathology, National Cancer Institute, Cairo University, Cairo, Egypt.
Appl Immunohistochem Mol Morphol. 2012 Mar;20(2):131-40. doi: 10.1097/pai.0b013e318228de00.
Thyroid neoplasms represent a broad spectrum of tumors with different biologic behaviors. Follicular neoplasms are classified as benign or malignant depending on the presence or absence of capsular and/or vascular invasion; however, evaluation of these features can be challenging on histopathologic examination. Galectin-3 is a member of lectin family and seems to play a significant role in a number of biological processes. p27 is a key regulator of progression from G1 to S phase.
In this study, we investigated the differential expression of both p27 and galectin-3 in both follicular adenomas and follicular carcinomas. The study was conducted on archival blocks retrieved from the pathology department at National Cancer Institute, Cairo University, diagnosed between 2001 and 2009 and included 22 cases of follicular adenomas, 22 cases of follicular adenomas with atypical features, 13 cases of minimally invasive follicular carcinomas, and 25 cases of widely invasive thyroid carcinomas.
p27 and galectin-3 immunohistochemical results were significantly different between follicular adenomas including those with atypical features and minimally and widely invasive follicular carcinomas with highly statistically significant difference, recording sensitivity of 100%, specificity of 97.4% as regards p27 and sensitivity of 71%, specificity of 86.36% as regards galectin-3.
p27 is a reliable marker in distinguishing follicular adenomas including atypical types from follicular carcinoma. Galectin-3 is also a fairly reliable marker in distinguishing follicular adenomas from carcinomas; however, it should be combined with other markers to increase its accuracy. We recommend the use of immunohistochemical panels of markers in follicular patterned thyroid lesions, notably in controversial cases.
甲状腺肿瘤是一类具有不同生物学行为的广泛肿瘤。滤泡性肿瘤根据有无包膜和/或血管侵犯分为良性或恶性；然而，在组织病理学检查中评估这些特征可能具有挑战性。半乳糖凝集素-3是凝集素家族的一员，似乎在许多生物学过程中发挥重要作用。p27是从G1期到S期进展的关键调节因子。
在本研究中，我们调查了p27和半乳糖凝集素-3在滤泡性腺瘤和滤泡性癌中的差异表达。该研究对从开罗大学国家癌症研究所病理科检索的存档切片进行，这些切片诊断于2001年至2009年期间，包括22例滤泡性腺瘤、22例具有非典型特征的滤泡性腺瘤、13例微侵袭性滤泡性癌和25例广泛侵袭性甲状腺癌。
p27和半乳糖凝集素-3免疫组化结果在包括具有非典型特征的滤泡性腺瘤与微侵袭性和广泛侵袭性滤泡性癌之间存在显著差异，具有高度统计学意义，p27的敏感性为100%，特异性为97.4%，半乳糖凝集素-3的敏感性为71%，特异性为86.36%。
p27是区分包括非典型类型的滤泡性腺瘤与滤泡性癌的可靠标志物。半乳糖凝集素-3也是区分滤泡性腺瘤与癌的相当可靠的标志物；然而，它应与其他标志物联合使用以提高其准确性。我们建议在滤泡型甲状腺病变中，特别是在有争议的病例中使用免疫组化标志物组合。
