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NRAS Q61R immunohistochemical staining in thyroid pathology: sensitivity, specificity and utility
Maelle Saliba1, Nora Katabi1, Snjezana Dogan1
1Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Histopathology
|May 7, 2021
Summary
Immunohistochemistry for NRAS Q61R is a sensitive and specific tool for diagnosing thyroid lesions, aiding in the identification of RAS Q61R mutations. This method is particularly useful for follicular-patterned neoplasms and classifying thyroid nodules.
Area of Science:
- Thyroid Pathology
- Molecular Diagnostics
- Oncology
Background:
- Diagnosing thyroid neoplasms often relies on histological parameters that can be focal and subjective.
- Accurate identification of specific mutations, such as RAS Q61R, is crucial for precise diagnosis and classification of thyroid lesions.
Purpose of the Study:
- To evaluate the diagnostic utility of NRAS Q61R immunohistochemistry (IHC) in thyroid lesions.
- To determine the specificity and sensitivity of NRAS Q61R IHC as a surrogate marker for RAS Q61R mutations.
Main Methods:
- NRAS Q61R IHC was performed on 282 thyroid lesions from 256 patients.
- RAS mutation status was retrospectively collected.
- Sensitivity and specificity of NRAS Q61R IHC for detecting RAS Q61R mutation were calculated.
Main Results:
- NRAS Q61R immunopositivity was observed in various thyroid lesions, including non-neoplastic, benign, and malignant types.
- The NRAS Q61R antibody demonstrated cross-reactivity with KRAS Q61R and HRAS Q61R proteins.
- Sensitivity and specificity of NRAS Q61R IHC for detecting RAS Q61R mutation were 90.6% and 92.3%, respectively; immunopositivity was most frequent in papillary thyroid carcinomas, follicular variant (48.0%).
Conclusions:
- NRAS Q61R IHC is a highly sensitive and specific method for detecting RAS Q61R mutations in thyroid pathology.
- This technique is especially relevant for follicular-patterned neoplasms.
- NRAS Q61R immunoreactivity aids in the diagnosis and classification of thyroid nodules when considered alongside histological features.
