갑상샘 결절의 수술 전 진단에서 초음파 유도하 심부 생검 면역 조직화학적 검사의 유용성
The Usefulness of Immunohistochemical Staining for Diagnosis of Thyroid Nodule in Preoperative Ultrasonography-Guided Core Needle Biopsy
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Background and Objectives The diagnosis of thyroid nodular diseases is critical for clinical management. Because of the histological similarity of follicular patterned thyroid lesions,the differential diagnosis is often difficult to determine, even with permanent sections. For this reason,we assessed the preoperative diagnostic usefulness of immunohistochemical staining for the four potential markers of malignant thyroid nodule, β-galactosil binding lectin (Galectin-3),Hector Battifora Mesothelial cell (HBME-1), cytokeratin-19 (CK-19) and high molecular weight cytokeratin (HMW-CK) in tissues obtained by ultrasound-guided core needle biopsy. Subjects and Method The immunohistochemical expression of Galectin-3, HBME-1, CK-19 and HMW-CK were evaluated in 43 preoperative thyroid lesions obtained to assess their potential as markers in the diagnosis and classification of thyroid malignancy. We compared the preoperative expression of the four markers with the results of postoperative permanent pathology. Results The expression patterns and positive rates of four markers were the variables in 4thyroid lesions; however, all markers were strong in malignant thyroid nodules, especially in papillary carcinoma. There were no significant differences in the expression rates of the four markers between follicular carcinoma and follicular adenoma. The sensitivity of HBME-1 for thyroid malignancy was the highest (86%) among the four markers, but the sensitivity of combinational expression using two markers, especially Galectin-3 or HBME-1 (95%), HBME-1 or HMW-CK (90%), was higher than that of the expression using one marker for thyroid malignancy. Conclusion The four markers were reliable markers for papillary carcinoma. In preoperative differential diagnosis of thyroid nodule, we suggest that the combinational expression using two makers is more useful than a single marker expression. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:564-70
Abstract
Background and Objectives The diagnosis of thyroid nodular diseases is critical for clinical management. Because of the histological similarity of follicular patterned thyroid lesions,the differential diagnosis is often difficult to determine, even with permanent sections. For this reason,we assessed the preoperative diagnostic usefulness of immunohistochemical staining for the four potential markers of malignant thyroid nodule, β-galactosil binding lectin (Galectin-3),Hector Battifora Mesothelial cell (HBME-1), cytokeratin-19 (CK-19) and high molecular weight cytokeratin (HMW-CK) in tissues obtained by ultrasound-guided core needle biopsy. Subjects and Method The immunohistochemical expression of Galectin-3, HBME-1, CK-19 and HMW-CK were evaluated in 43 preoperative thyroid lesions obtained to assess their potential as markers in the diagnosis and classification of thyroid malignancy. We compared the preoperative expression of the four markers with the results of postoperative permanent pathology. Results The expression patterns and positive rates of four markers were the variables in 4thyroid lesions; however, all markers were strong in malignant thyroid nodules, especially in papillary carcinoma. There were no significant differences in the expression rates of the four markers between follicular carcinoma and follicular adenoma. The sensitivity of HBME-1 for thyroid malignancy was the highest (86%) among the four markers, but the sensitivity of combinational expression using two markers, especially Galectin-3 or HBME-1 (95%), HBME-1 or HMW-CK (90%), was higher than that of the expression using one marker for thyroid malignancy. Conclusion The four markers were reliable markers for papillary carcinoma. In preoperative differential diagnosis of thyroid nodule, we suggest that the combinational expression using two makers is more useful than a single marker expression. Korean J Otorhinolaryngol-Head Neck Surg 2010;53:564-70
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