Das Dilip K, Al-Waheeb Salah K M, George Sara S, Haji Bahiyah I, Mallik Mrinmay K
Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait; Cytology Unit, Mubarak Al-Kabeer Hospital, Kuwait.
Diagn Cytopathol. 2014 Jun;42(6):498-505. doi: 10.1002/dc.23062. Epub 2013 Nov 22.
In cytology practice some papillary thyroid carcinoma (PTC) cases have indeterminate diagnoses and overlapping cytological features with benign lesions. This study was undertaken to find out if immunocytochemistry using Galectin-3, CD-44 and HBME-1 could be of help in such situations. Forty-six cases consisting of 22 malignancy (PTC) cases, 7 suspicious of (S/O) PTC, 1 follicular neoplasm, 5 follicular lesion of undetermined significance (FLUS), and 11 benign (colloid goiter) cases diagnosed by FNA were included in this study. Staining reactions were graded in a sliding scale of -, 1+, 2+, 3+, and 4+. In an assessment of 100 cells, each cell with weak, and moderate to strong positive reaction were assigned a score of 1 and 4, respectively. Staining reaction of ≥+2 and scores >100 were considered positive. Frequency of cases with ≥+2 reaction, and scores >100 for each of Galectin-3, CD-44, and HBME-1 were significantly higher in PTC or combined PTC and S/O PTC cases as compared with FLUS and benign cases taken together (P = 0.01744 to 0.00000). When the cases were compared according to histological malignant and benign diagnoses, the difference was also significant in respect of ≥+2 reaction, and scores >100 for Galectin-3 and CD44 (P = 0.04923 to 0.00947); however, there was no significant difference, when these parameters for HBME1 were compared. Galectin 3, CD 44, and to some extent HBME 1 are useful immunocytochemical parameters with potential to support FNAC diagnosis of PTC, especially in situations with difficult differential diagnoses.
在细胞学实践中，一些甲状腺乳头状癌（PTC）病例的诊断不明确，且具有与良性病变重叠的细胞学特征。本研究旨在探讨使用半乳糖凝集素-3、CD-44和HBME-1进行免疫细胞化学检测在这种情况下是否有帮助。本研究纳入了46例经细针穿刺活检（FNA）诊断的病例，其中包括22例恶性（PTC）病例、7例疑似（S/O）PTC病例、1例滤泡性肿瘤、5例意义未明的滤泡性病变（FLUS）和11例良性（胶样甲状腺肿）病例。染色反应按-、1+、2+、3+和4+的滑动量表进行分级。在对100个细胞进行评估时，每个弱阳性以及中度至强阳性反应的细胞分别计分为1分和4分。染色反应≥+2且得分>100被视为阳性。与FLUS和良性病例合并相比，PTC或PTC与S/O PTC合并病例中，半乳糖凝集素-3、CD-44和HBME-1中每一项出现≥+2反应且得分>100的病例频率显著更高（P = 0.01744至0.00000）。当根据组织学恶性和良性诊断对病例进行比较时，半乳糖凝集素-3和CD44出现≥+2反应且得分>100的差异也具有统计学意义（P = 0.04923至0.00947）；然而，比较HBME1的这些参数时，差异无统计学意义。半乳糖凝集素-3、CD-44以及在一定程度上的HBME-1是有用的免疫细胞化学参数，有可能支持FNA对PTC的诊断，尤其是在鉴别诊断困难的情况下。
