Department of Surgery, Pauls Stradins University Hospital, Pilsonu 13, 1004, Riga, Latvia.
Medicina (Kaunas). 2012;48(10):507-14.
Distinction between benign and malignant thyroid tumors is essential for proper clinical management. The aim of this study was to evaluate the diagnostic potential of a set of 3 molecular markers in the differential diagnosis of thyroid tumors.
Immunohistochemistry for HBME-1, E-cadherin (E-CAD), and CD56 was carried out in 36 follicular adenomas, 77 colloid goiters, 36 papillary thyroid carcinomas, and 14 follicular carcinomas. Sixty-eight thyroid fine needle aspiration (FNA) cases confirmed by subsequent surgical resection specimens were selected. Immunocytochemistry for HBME-1, E-CAD, and CD56 was performed in these cases, including 25 papillary thyroid carcinomas, 1 follicular carcinoma, 22 follicular adenomas, and 20 colloid goiters.
PTC was characterized by a decreased expression of E-CAD and CD56 contrary to the surrounding benign thyroid tissues. There was no HBME-1 expression in benign thyroid tissues, but it was high in papillary thyroid carcinomas and weak in follicular adenomas. The expression of E-CAD and CD56 was significantly higher in follicular adenomas than in the surrounding thyroid tissues. Analyzing the FNA material, HBME-1 expression was documented in 96% of papillary thyroid carcinomas, but there was no expression in the benign lesions. E-CAD and CD56 expression was significantly weakened in papillary thyroid carcinomas, but enhanced in follicular adenomas.
HBME-1 was found only in malignant lesions and can be considered the most sensitive, specific single marker in papillary thyroid carcinomas. CD56 and E-CAD can assist in the decision-making on the benign and malignant nature of the nodule. Immunocytochemistry is of value as an ancillary test to enhance the diagnostic accuracy of thyroid FNA samples.
区分良性和恶性甲状腺肿瘤对于正确的临床管理至关重要。本研究旨在评估一组 3 种分子标志物在甲状腺肿瘤鉴别诊断中的诊断潜力。
对 36 例滤泡性腺瘤、77 例胶体性甲状腺肿、36 例甲状腺乳头状癌和 14 例滤泡癌进行 HBME-1、E-钙黏蛋白（E-CAD）和 CD56 的免疫组织化学染色。选择 68 例经后续手术切除标本证实的甲状腺细针抽吸（FNA）病例。对这些病例进行 HBME-1、E-CAD 和 CD56 的免疫细胞化学染色，包括 25 例甲状腺乳头状癌、1 例滤泡癌、22 例滤泡性腺瘤和 20 例胶体性甲状腺肿。
与周围良性甲状腺组织相比，PTC 的 E-CAD 和 CD56 表达降低。良性甲状腺组织无 HBME-1 表达，而甲状腺乳头状癌高表达，滤泡性腺瘤弱表达。E-CAD 和 CD56 在滤泡性腺瘤中的表达明显高于周围甲状腺组织。分析 FNA 材料，HBME-1 在 96%的甲状腺乳头状癌中表达，但在良性病变中无表达。E-CAD 和 CD56 的表达在甲状腺乳头状癌中明显减弱，但在滤泡性腺瘤中增强。
HBME-1 仅在恶性病变中发现，可被认为是甲状腺乳头状癌最敏感、特异的单一标志物。CD56 和 E-CAD 可辅助判断结节的良恶性。免疫细胞化学作为辅助检测方法，可提高甲状腺 FNA 样本的诊断准确性。
