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Published on: July 21, 2009
Immunocytochemical analysis for differential diagnosis of thyroid lesions using liquid-based cytology
Katsunori Hashimoto1, Ayumi Morimoto, Makoto Kato
1Department of Medical Technology, Nagoya University School of Health Sciences, Nagoya, Japan. khashimo@met.nagoya-u.ac.jp
Insights
Liquid-based cytology combined with immunocytochemistry improves thyroid cancer diagnosis. A panel of markers, including 34betaE12, galectin-3, and cytokeratin 19, offers high accuracy for papillary carcinoma detection.
Area of Science:
- Cytopathology
- Oncology
- Immunohistochemistry
Background:
- Liquid-based cytology (LBC) is increasingly used in diagnostic cytology.
- Objective diagnosis and improved accuracy in thyroid cytology are needed.
Purpose of the Study:
- To evaluate the utility of LBC combined with immunocytochemistry for thyroid cytology.
- To identify reliable immunocytochemical markers for diagnosing thyroid papillary carcinoma (PC).
Main Methods:
- 125 thyroid cytology cases were analyzed using LBC.
- Immunocytochemical staining was performed with six antibodies: HBME-1, cytokeratin 19 (CK19), 34betaE12, galectin-3, CD15, and CA 19-9.
- A panel of 34betaE12, galectin-3, and CK19 was assessed for diagnostic performance.
Main Results:
- Individual antibodies showed frequent positivity in PCs.
- The antibody 34betaE12 demonstrated high sensitivity (82.5%), specificity (100%), and accuracy (92.0%).
- The panel of 34betaE12, galectin-3, and CK19 achieved superior sensitivity (93.0%), specificity (100%), and accuracy (96.8%) compared to single markers.
Conclusions:
- A panel of immunocytochemical markers (34betaE12, galectin-3, CK19) enhances diagnostic objectivity and accuracy in thyroid cytology.
- This panel is effective for differentiating papillary carcinomas from other thyroid lesions.
- The combined approach of LBC and immunocytochemistry offers a valuable tool for thyroid cancer diagnosis.
Abstract:
Recently, liquid-based cytology (LBC) has been widely applied to various samples in diagnostic cytology and its usefulness has been reported. In this study, we investigated thyroid cytology that applied LBC and immunocytochemistry to achieve more objective diagnosis and greater diagnostic accuracy. This study included 125 cases (57 papillary carcinomas (PCs), 22 follicular tumors, 43 adenomatous goiters and 3 with Basedow's disease). After preparing the LBC slide, immunocytochemical staining was performed on each slide with six antibodies (HBME-1, cytokeratin 19 (CK19), high molecular weight cytokeratin (34JE12), galectin-3, CD15 and CA 19-9). All antibodies presented immunopositivity frequently in PCs, but only a few or some of them were positive in other cases. These antibodies were considered positive markers for PCs, and the most reliable marker was 34betaE12; its sensitivity, specificity and diagnostic accuracy were 82.5%, 100% and 92.0%, respectively. Relations of immunocytochemical profiles against these markers were assessed using panel 34betaE12, GAL-3 and CK19. More than or equal to two of these markers showed co-positive in 53 of 57 PCs, and negative for all markers was observed in only one case. In the other (non PC) cases, the former was 0 of 58 and the latter was 40 cases. In this panel, the sensitivity, specificity and diagnostic accuracy were 93.0%, 100% and 96.8%, respectively. All of these values were higher than or equal to single values of 34betaE12. We concluded that the panel in this study is useful for more objective and accurate diagnosis of thyroid cytology.
