Muzafar Alliya, Bukhari Mulazim Hussain, Qureshi Ihtesham Uddin
Dr. Alliya Muzafar, MBBS, M.Phil. Senior Demonstrator Pathology, King Edward Medical University, Lahore, Pakistan.
Prof. Dr. Mulazim Hussain Bukhari, MBBS, FCPS, PhD. Head of Department Pathology, University Medical College, University of Lahore, Lahore, Pakistan.
Pak J Med Sci. 2017 May-Jun;33(3):726-731. doi: 10.12669/pjms.333.12251.
BACKGROUND & OBJECTIVE: Thyroid nodules are very common in our setup and their diagnosis on fine needle aspiration is not easy and is a taxing affair. It is a challenge to differentiate between follicular adenoma and follicular carcinoma without histology. Our objective was to investigate the role of Galectin-3 in fine needle aspirates of thyroid nodules as a prospective diagnostic marker and consequently its ability to differentiate benign from malignant neoplasms.
The research was conducted at the department of Pathology, King Edward Medical University, in association with other teaching institutions of Lahore from June 2012 to July 2014.. Sixty cases of solitary thyroid nodules were included in the study. Haematoxylin and eosin staining of the fixed smears and Galectin-3 immunohistochemical staining of the sections prepared from the cell block was performed.
There were 60 patients in our study with a mean age of 33.35 years. The Bethesda system for reporting thyroid cytopathology was used to classify the smears and only categories IV, V and VI were included. On histological examination of the resected nodules there were 38.3% (23/60) cases of follicular adenoma, 46.6% (28/60) were of papillary carcinoma and follicular carcinoma made up to 15% (9/60) of all cases. Galectin-3 was negative in 100% (23/23) cases of follicular adenomas. Out of 37 malignant cases 65% lesions showed positivity, while 35% showed negativity for this immunomarker. Considering the malignant lesions, 75% cases of papillary carcinomas showed a positive reaction while only 33% of follicular carcinomas were positive for the immunomarker. This showed that the positive expression was more common in papillary as compared to follicular carcinomas.
Galectin-3immunomarker is considerably expressed in malignant tumors, but it is not expressed in benign follicular lesions.
甲状腺结节在我们的研究中非常常见，通过细针穿刺进行诊断并非易事，且是一项费力的工作。在没有组织学检查的情况下，区分滤泡性腺瘤和滤泡性癌是一项挑战。我们的目的是研究半乳糖凝集素-3在甲状腺结节细针穿刺抽吸物中作为一种前瞻性诊断标志物的作用，以及其区分良性和恶性肿瘤的能力。
该研究于2012年6月至2014年7月在爱德华国王医科大学病理科与拉合尔的其他教学机构联合开展。本研究纳入了60例孤立性甲状腺结节病例。对固定涂片进行苏木精和伊红染色，并对从细胞块制备的切片进行半乳糖凝集素-3免疫组织化学染色。
我们的研究中有60例患者，平均年龄为33.35岁。采用甲状腺细胞病理学报告的贝塞斯达系统对涂片进行分类，仅纳入IV、V和VI类。对切除结节进行组织学检查，滤泡性腺瘤病例占38.3%（23/60），乳头状癌占46.6%（28/60），滤泡性癌占所有病例的15%（9/60）。在滤泡性腺瘤的所有病例（23/23）中，半乳糖凝集素-3均为阴性。在37例恶性病例中，65%的病变呈阳性，而35%的病变对此免疫标志物呈阴性。在恶性病变中，75%的乳头状癌病例呈阳性反应，而只有33%的滤泡性癌对该免疫标志物呈阳性。这表明与滤泡性癌相比，阳性表达在乳头状癌中更为常见。
半乳糖凝集素-3免疫标志物在恶性肿瘤中大量表达，但在良性滤泡性病变中不表达。
