Diagnostic utility of immunohistochemical panel in various thyroid pathologies

Area of Science:

• Endocrinology
• Oncology
• Pathology

Background:

• Distinguishing benign from malignant thyroid nodules is crucial for effective patient management.
• Molecular markers offer potential for improved diagnostic accuracy in thyroid tumor classification.

Purpose of the Study:

• To evaluate the diagnostic utility of specific molecular markers in differentiating various thyroid tumors.
• To assess the expression patterns of CD56, HBME-1, COX-2, Ki-67, p53, and E-cadherin (E-CAD) in benign and malignant thyroid lesions.

Main Methods:

• Immunohistochemistry was performed on 113 benign and 35 malignant thyroid lesions, including follicular adenomas (FA), colloid goitres, papillary thyroid carcinomas (PTC), and follicular carcinomas (FC).
• Expression levels of CD56, HBME-1, COX-2, Ki-67, p53, and E-CAD were semiquantitatively scored based on staining intensity and percentage of positive cells.

Main Results:

• Papillary thyroid carcinoma (PTC) showed decreased E-CAD and CD56 expression compared to benign tissues.
• HBME-1 expression was high in PTC and FC, but absent in benign tissues, identifying it as a sensitive marker for malignancy.
• Follicular adenomas (FA) and follicular carcinomas (FC) exhibited higher E-CAD and CD56 expression than surrounding tissues, distinguishing them from PTC.

Conclusions:

• A panel of HBME-1, E-CAD, and CD56 can augment morphological criteria for thyroid tumor diagnosis.
• HBME-1 is the most sensitive and specific marker for PTC.
• E-CAD and CD56 expression patterns effectively differentiate PTC from FA and FC, highlighting the importance of adhesion factors in thyroid malignancies.