An Immunohistochemical Study of Cytokeratin and Vimentin in Benign and Malignant Thyroid Lesions

Intermediate filaments in benign and malignant thyroid lesions were immunohistochemically studied using polyclonal and monoclonal anti-cytokeratin (CK), and monoclonal anti-vimentin antibodies. Antigenicity of CK and vimentin was almost completely destroyed during formalin fixation in normal thyroid and all thyroid lesions except for some cases of papillary and squamous cell carcinoma, although the latter showed negative immunostaining with anti-vimentin antibody. In sections fixed with Carnoy's fixative, most cases of papillary carcinoma showed an intense reaction product for polyclonal anti-CK, monoclonal anti-CK-7, CK-19 and anti-vimentin antibodies. The reaction product for anti-CK antibodies was located mainly in the apical cytoplasm and that for anti-vimentin antibody in the basal cytoplasm. However antigenicity was still destroyed by the fixative in many specimens of normal thyroid, benign thyroid lesions and follicular carcinoma. In frozen sections, all specimens showed preserved antigenicity for both antigens with an intense reaction product in papillary carcinoma, but this was weaker in normal thyroid, benign thyroid lesions and follicular carcinoma. Therefore, follicular cells under normal and pathological conditions contain intermediate filaments of CK and vimentin in their cytoplasm and co-expression of the antigens is significantly increased in papillary carcinoma.     

An immunohistochemical study of cytokeratin and vimentin in benign and malignant thyroid lesions

Intermediate filaments in benign and malignant thyroid lesions were immunohistochemically studied using polyclonal and monoclonal anti-cytokeratin (CK), and monoclonal anti-vimentin antibodies. Antigenicity of CK and vimentin was almost completely destroyed during formalin fixation in normal thyroid and all thyroid lesions except for some cases of papillary and squamous cell carcinoma, although the latter showed negative immunostaining with anti-vimentin antibody. In sections fixed with Carnoy's fixative, most cases of papillary carcinoma showed an intense reaction product for polyclonal anti-CK, monoclonal anti-CK-7, CK-19 and anti-vimentin antibodies. The reaction product for anti-CK antibodies was located mainly in the apical cytoplasm and that for anti-vimentin antibody in the basal cytoplasm. However antigenicity was still destroyed by the fixative in many specimens of normal thyroid, benign thyroid lesions and follicular carcinoma. In frozen sections, all specimens showed preserved antigenicity for both antigens with an intense reaction product in papillary carcinoma, but this was weaker in normal thyroid, benign thyroid lesions and follicular carcinoma. Therefore, follicular cells under normal and pathological conditions contain intermediate filaments of CK and vimentin in their cytoplasm and co-expression of the antigens is significantly increased in papillary carcinoma.     

Can CD10 be used as a diagnostic marker in thyroid pathology?

CD10–common acute lymphoblastic leukemia antigen is a membrane-bound zinc metalloproteinase that is expressed by different hematopoietic cell types at unique stages of lymphoid and myeloid differentiation. It was reported to be expressed in various nonlymphoid cells and tissue, as well as in various types of neoplasms. Recently, it has been found to be useful in the differential diagnosis of benign and malignant follicular-patterned lesions of the thyroid. In the present study, we evaluated the staining pattern of CD10 in various thyroid lesions, including 14 benign and 61 malignant cases, as well as in adjacent thyroid tissue. CD10 was negative in normal thyroid tissue, adenomatous nodules, minimally invasive follicular carcinoma, and well-differentiated carcinoma. It was expressed in nine of 14 (64.2%) conventional papillary carcinomas, four of 24 (16.6%) follicular variant of papillary carcinomas, three of six (50%) papillary microcarcinomas, one of nine (11.1%) widely invasive follicular carcinomas, and three of ten (30%) follicular adenomas. In contrast to results of previous studies, CD10 is not useful in the classification of thyroid follicular lesions as benign or malignant, but it shows strong positivity in conventional papillary carcinoma.     

Expression of keratin 19 distinguishes papillary thyroid carcinoma from follicular carcinomas and follicular thyroid adenoma

Keratin expression with the use of chain-specific monoclonal antikeratin antibodies was investigated in normal thyroid tissue (n = 4), colloid nodules (n = 19), follicular thyroid adenomas (n = 18), follicular carcinomas (n = 10), and papillary carcinomas (n = 12). Frozen sections were stained with monoclonal antibodies M20 (keratin 8), M9 (keratin 18), and LP2K (keratin 19) with the use of the indirect immunoperoxidase technique. The immunohistochemical findings showed that the expression of keratins 8 and 18 was equally extensive in all normal, benign, and malignant lesions tested. In contrast, different staining patterns were observed with the use of monoclonal antibody to keratin 19. Follicular carcinomas were only focally stained with this antibody or were not reactive at all. Keratin 19, however, was present in all the tumor cells of papillary tissues and in a moderate amount of cells of nonneoplastic thyroid lesions and follicular adenomas. In papillary carcinoma, an identical homogeneous expression of keratin 19 was observed in both papillary and follicular structures, which suggests a common cellular origin. These results show that immunohistochemical staining with the use of monoclonal antibody against keratin 19 is useful to distinguish papillary thyroid carcinomas from follicular adenomas and follicular thyroid carcinomas.     

Intermediate filaments in cytological specimens of thyroid tumors

Cytological specimens of thyroid carcinomas and follicular adenomas obtained by fine-needle aspiration biopsies or touch imprints were investigated with antibodies to keratin, vimentin, and neurofilaments. All tumors were keratin positive. In follicular adenomas as well as in papillary thyroid carcinomas, a coexpression of keratin and vimentin was detected; in follicular carcinomas, only some tumors showed coexpression of keratin and vimentin; and in medullary thyroid carcinomas, positive staining of all six tumors studied was seen with the keratin and neurofilament antibodies, with some tumors also showing coexpression of vimentin. The mechanisms of such coexpression is unclear.     

Expression of sodium iodide symporter in benign and malignant human thyroid tissues

The extent of human sodium iodide symporter (hNIS) expression in different kinds of human thyroid cancer tissues and cell lines remains controversial. In this study, polyclonal antibodies to hNIS were used to analyze the expression of symporter protein in benign and malignant human thyroid tissues. Formalin-fixed, paraffin wax-embedded tissue sections were used. Staining was performed using primary polyclonal antibody of rabbit anti-human hNIS diluted in PBS (1:500). Results showed that 2 of 3 normal tissue, 3 of nodular hyperplasia, one follicular adenoma, 3 of 11 papillary thyroid carcinoma, 1 of 5 follicular carcinoma and none of 3 metastatic thyroid epithelial tissue specimens stained positively for hNIS. A higher percentage of positive staining for symporter protein was found in benign thyroid tissues including normal thyroid tissue, nodular hyperplasia, and adenoma (60%). In contrast, papillary and follicular thyroid carcinomas demonstrated lower symporter protein expression (20%). In conclusion, although the number of tissue samples examined in this study was small, hNIS staining found a higher ratio of symporter protein expression in normal and benign thyroid tissues compared with malignant tissues. Determination of the reason for discrepancies in the expression of hNIS in in vivo and in vitro studies will require further investigation.     

Differential expression of galectin-1 and galectin-3 in thyroid tumors. Potential diagnostic implications.

Carcinoma of the thyroid gland, the most frequently diagnosed endocrine malignancy, is often associated with early regional metastases. With the exception of papillary carcinoma, distinguishing benign from malignant thyroid neoplasms in the absence of metastatic disease is difficult. Recently, the vertebrate lectins galectin-1 and galectin-3 have been implicated in the regulation of cellular growth, differentiation, and malignant transformation of a variety of tissues. To determine whether these galectins have a role in thyroid neoplasia, we analyzed 32 specimens from thyroid malignancies (16 papillary, 7 follicular, 8 medullary carcinomas, and 1 metastasis to lymph node), 10 benign thyroid adenomas, 1 nodular goiter, and 33 specimens from adjacent normal thyroid tissue for the expression of galectin-1 and galectin-3 with immunohistochemical and immunoblotting techniques utilizing anti-galectin antibodies. All thyroid malignancies of epithelial origin (ie, papillary and follicular carcinomas) and a metastatic lymph node from a papillary carcinoma expressed high levels of both galectin-1 and galectin-3. The medullary thyroid carcinomas, which are of parafollicular C cell origin, showed a weaker and variable expression of these galectins. In contrast, neither benign thyroid adenomas nor adjacent normal thyroid tissue expressed galectin-1 or galectin-3. These results suggest that galectin-1 and galectin-3 may be associated with malignant transformation of thyroid epithelium and may potentially serve as markers for distinguishing benign thyroid adenomas from differentiated thyroid carcinomas.     

Simultaneous immunohistochemical expression of HBME-1 and galectin-3 differentiates papillary carcinomas from hyperfunctioning lesions of the thyroid

AIMS: The histological diagnosis is critical for the postsurgical management and follow-up of thyroid malignancies. The differential diagnosis between papillary carcinoma and hyperfunctioning lesions, either with papillary hyperplasia or with a follicular architecture, can create real diagnostic difficulty. The aim of this study was to evaluate the expression of several antibodies considered to be markers of malignancy in malignant and hyperfunctioning thyroid neoplasms and to include the most effective of them in a diagnostic panel. METHODS AND RESULTS: One hundred resected thyroid nodules--58 hyperfunctioning benign lesions and 42 papillary carcinomas (14 follicular variant, 14 macrofollicular variant and 14 classic type)--were immunohistochemically studied for HBME-1, galectin-3, cytokeratin (CK) 19 and RET-proto-oncogene. HBME-1 and galectin-3 showed 92.8% and 89% sensitivity, respectively, and their coexpression was present in 36 out of 42 papillary carcinomas (85.7%) and absent in non-malignant lesions. Their association increased sensitivity to 94.7% and the diagnostic accuracy to 97.9% and involved the highest number of cases (95%) in comparison with two other panels including, respectively, three (HBME-1, galectin-3, CK19) and all four antibodies. CONCLUSION: An immunohistochemical panel consisting of HBME-1 and galectin-3 can make a correct distinction between malignant and hyperfunctioning thyroid neoplasms with high diagnostic accuracy.     

Galectin-3 does not reliably distinguish benign from malignant thyroid neoplasms

AIMS: To determine whether galectin-3 is a sensitive indicator of thyroid malignancy. It has been suggested as a potential marker for differentiating thyroid carcinoma from benign or non-neoplastic lesions in preoperative fine-needle aspirates (FNAs). METHODS: Galectin-3 protein expression was assessed by immunohistochemistry in formalin-fixed thyroid tissues from 124 patients with histological diagnoses of papillary carcinoma (n = 38), follicular carcinoma (n = 19), follicular adenoma (n = 32) and dominant nodules of multinodular goitre (n = 35). Expression of galectin-3 was also assessed by Western blotting in 24 fresh thyroid tissues. RESULTS: Galectin-3 expression was observed in the majority of carcinomas (papillary 92%; follicular 74%). However, a large proportion of follicular adenomas (72%) and multinodular goitres (57%) also expressed galectin-3. In addition, galectin-3 expression was observed in epithelial cells of normal thyroid tissue and Hashimoto's thyroiditis. Galectin-3 immunopositivity was significantly greater in papillary carcinomas than in dominant nodules or follicular adenomas (P < 0.0001, P = 0.0005, respectively). However, galectin-3 expression was no greater in follicular carcinomas than in follicular adenomas (P = 0.8735). Western blotting analysis confirmed both the specificity of the antiserum and expression of galectin-3 in multinodular goitres, follicular adenomas/carcinomas and papillary carcinomas. CONCLUSION: The data demonstrate that galectin-3 is not a reliable immunohistochemical marker to distinguish benign from malignant thyroid follicular lesions.     

Immunohistochemical separation of follicular variant of papillary thyroid carcinoma from follicular adenoma

The accurate diagnosis of differentiated thyroid tumors is very important for clinical management of patients. The histopathological distinction between some types of differentiated thyroid tumors can be very difficult even for experienced pathologists. We used immunohistochemical markers from published data obtained from DNA expression profiling, tissue microarray analysis, and immunohistochemistry to analyze a series of 157 thyroid tumors and 5 normal thyroids. These analyses showed that several antibodies were useful in distinguishing follicular adenomas from follicular variant of papillary thyroid carcinomas including HBME-1, CITED 1, galectin-3, cytokeratin 19, and S100A4 (p<0.0001). A combination of markers consisting of a panel of HBME-1, galectin-3, and CK19 or a panel of HBME-1, CITED1, and galectin-3 was usually most effective in distinguishing follicular adenoma from follicular variant of papillary thyroid carcinoma. Because individual tumors may not express some of these markers, the use of a panel of antibodies is recommended. These results indicate that some individual antibodies or a panel of antibodies combined with histopathological analysis can be useful in separating follicular adenoma (FA) from follicular variant of papillary thyroid carcinoma (FVPTC).     

CD57 (leu-7) Expression is helpful in diagnosis of the follicular variant of papillary thyroid carcinoma

 CD57 (HNK-1) is a oligosaccharide antigen that is expressed by cells of several lineages. It is present on multipotential neuroepithelial cells during embryogenesis, and tumours of epithelial, neuroectodermal and nerve sheath origin also express CD57. Its role in the diagnosis of thyroid tumours is controversial. We have studied CD57 expression by immunohistochemistry to determine its utility in the classification of thyroid follicular lesions. Study material included 114 normal thyroid sections, 77 benign thyroid lesions (29 colloid nodules, 22 follicular adenomas, 20 cases of Hashimoto’s thyroiditis and 6 of Grave’s disease) and 83 thyroid carcinomas, including 31 follicular variants of papillary carcinoma. We observed CD57 positivity in 95% of thyroid carcinomas, 27% of follicular adenomas and 10% of colloid nodules. It was not expressed in the normal thyroid. CD57 expression in thyroid carcinomas was significantly different from that in normal and benign thyroid lesions (P < 0.0001). The follicular variant of papillary thyroid carcinoma also showed significantly higher CD57 expression than colloid nodules (P < 0.0009) or follicular adenomas (P < 0.0009). No significant difference was seen between colloid nodules and follicular adenomas. We conclude that CD57 immunohistochemistry is valuable in the classification of thyroid follicular lesions into benign and malignant groups and is also helpful in the diagnosis of the follicular variant of papillary thyroid carcinoma. Received: 26 August 1997 / Accepted: 14 October 1997     

Lectin histochemistry of papillary and follicular carcinoma of the thyroid gland

The lectin-binding properties of human follicular and papillary carcinoma were studied histochemically and compared with lectin binding to normal or goitrous thyroid tissue. Well-differentiated minimally invasive follicular carcinoma showed a lectin-binding pattern essentially identical to those of the normal thyroid gland and benign adenomatous lesions. Overtly invasive follicular carcinoma showed focal reactivity with some lectins that were nonreactive with normal follicular thyroid cells (Solanum tuberosum and soybean in three of three cases; Ulex europaeus in two of three cases; and Dolichos biflorus, Laburnum alpinum, and peanut in one of three cases). In papillary carcinomas, the cells lining the papillary structures reacted focally with some lectins that did not bind to normal thyroid cells (S tuberosum and U europeaus in seven of seven cases; Helix pomatia, Helix aspersa, and soybean in four of seven cases; and peanut, Griffonia simplicifolia, D biflorus, and Vicia villosa in one of seven cases). All these lectins, as well as those reacting with normal thyroid cells, reacted more strongly with cells of papillary structures than with those forming solid nests and follicles. Despite these lectin-defined differences in the composition of glycoconjugates of benign and malignant thyroid cells, the inconsistent and focal nature of the changes precludes the use of lectins in diagnostic histopathology.     

Differential expression of cytokeratins in follicular variant of papillary carcinoma: an immunohistochemical study and its diagnostic utility.

The follicular variant of papillary carcinoma (FVPTC) is characterized by follicular growth pattern and tumor cells with appropriate nuclear features of papillary carcinoma. However, occasionally these lesions may show focal or multifocal instead of diffuse distribution of nuclear features of papillary carcinoma. Such lesions can be underdiagnosed as benign follicular nodule. Previous studies have shown that cytokeratins, especially 19, are helpful in differentiating papillary carcinoma from other benign and malignant follicular patterned lesions. In this study, we applied monoclonal antibodies to CK5/6/18, CK18, CK10/13, CK20, CK17, and CK19 to paraffin sections of formaldehyde-fixed tissue from 26 cases of FVPTC with multifocal distribution of papillary cancer nuclei, 10 cases of usual variant of papillary carcinoma, 1 case of Warthin's tumor-like papillary carcinoma, and 2 cases of the columnar cell carcinoma. CK19 stained strongly and diffusely all cases of papillary carcinoma. FVPTC cases showed strong staining of the areas with papillary cancer nuclei in all cases and moderate to strong staining in areas of tumor without obvious nuclear features of papillary cancer. Normal thyroid parenchyma adjacent to the tumor nodule showed focal staining in most cases; however, tissue away from the tumor nodule failed to show any staining. All cases of usual type of papillary carcinoma, 2 of columnar cell carcinoma, and 1 Warthin's tumor-like papillary carcinoma showed strong and diffuse staining with CK19 and failed to show any staining of adjacent normal thyroid parenchyma. Similar but less intense staining patterns were seen with CK17 and CK20. The control group, consisting of cases of follicular adenoma, follicular carcinoma, and hyperplastic nodule, showed no staining with CK19. We suggest that if one is using immunohistochemistry to aid in the diagnosis of cases of FVPTC with multifocal distribution of nuclear features of papillary cancer, an antibody panel comprising CKs 17, 19, and 20 may prove helpful. In addition, we hypothesize that the staining of adjacent nontumorous thyroid parenchyma with CK19, seen only in cases of FVPTC, suggests that some factors secreted/produced by this particular tumor may lead to modification in keratin expression of surrounding follicular epithelium.     

Diagnostic usefulness of dipeptidyl aminopeptidase IV monoclonal antibody in paraffin-embedded thyroid follicular tumours.

Monoclonal antibodies to dipeptidyl aminopeptidase IV (DAP IV, EC 3.4.14.5) were raised and selectively applied to paraffin-embedded sections of thyroid carcinoma. Five monoclonal antibodies were found to stain paraffin sections of thyroid carcinomas. Using one of these antibodies (44-4), we studied retrospectively aberrant expression of DAP IV in thyroid carcinoma to determine whether immunohistochemical staining with DAP IV antibody is useful in pathological diagnosis. In almost all cases of thyroid follicular and papillary carcinoma, tumour cells were positive (99.0 per cent) with DAP IV, whereas the cases of follicular adenoma showed a low incidence (27.1 per cent) of positive staining. Follicular adenoma with incomplete capsular invasion had a higher positive incidence (50 per cent) than follicular adenoma without incomplete capsular invasion (9.6 per cent). In positive staining cases previously diagnosed as benign tumours, 11 benign cases reacting positively with DAP IV were rediagnosed as carcinoma after re-examination of more thyroid paraffin block sections or serial sections. These findings suggest that DAP IV monoclonal antibody is very useful in distinguishing thyroid follicular carcinoma from follicular adenoma.     

Ultrastructural observations on the capillaries of human thyroid tumours.

Ultrastructure of the capillaries of malignant and benign thyroid tumours has been examined. The material consisted of biopsies from six cases of thyroid papillary carcinoma, one case of follicular (foetal type) adenoma and six cases of nodular adenomatous goitre. In the group of nodular adenomatous goitre and in the follicular adenoma, the capillary wall was made up of fenestrated endothelium similar to that of capillaries of normal human thyroid. The fenestrae occupied a large area of the endothelial wall. Micro- and macropinocytotic vesicles were frequent in the endothelial cytoplasm. In the thyroid carcinomas the papillary structures always contained numerous capillaries with fenestrated endothelium. The microfollicular area and the solid tumoral areas of the papillary carcinoma showed occasional capillaries with fenestrated endothelium, but many capillaries were lined with continuous endothelium. The capillaries in all the specimens were surrounded externally by a continuous basement membrane which was frequently bilaminate or multilaminate. This study indicates that capillaries with fenestrated endothelium are characteristic of thyroid tumours which arise from follicular cells.     

Expression of intermediate filament proteins in thyroid gland and thyroid tumors

The presence of intermediate filament proteins of cytokeratin/prekeratin type and vimentin type was evaluated in non-neoplastic thyroid glands and in different types of thyroid neoplasms. Follicular epithelium of both normal and goitrous thyroids showed a strong reaction with anticytokeratin antibodies that widely cross-react with various simple epithelia. On the other hand, in normal thyroid, there were only occasionally (in one of 12 cases) solitary cells reacting with antibodies to epidermal prekeratin. In nodular goiters, such cells were often seen (eight of 18), especially among the lining cells of cysts, and in chronic thyroiditis in all (12 of 12) cases. Only the stromal cells and intraluminal macrophages reacted with antibodies to vimentin. Neoplastic cells of papillary carcinomas showed a positive staining reaction both with antibodies to cytokeratins and to epidermal prekeratin. Follicular carcinoma cells, although positive for cytokeratins, could generally not be stained with antibodies to epidermal prekeratin. Medullary carcinoma cells also showed cytokeratin positivity and, only occasionally, positivity for epidermal prekeratin. Anaplastic carcinomas were also reactive with antibodies to cytokeratin but, for the most part, were negative for epidermal prekeratin. Interestingly, some neoplastic cells of all types of thyroid carcinomas also appeared to contain vimentin, as shown with both polyclonal and monoclonal antivimentin antibodies. In contrast to carcinomas, the intermediate filaments of thyroid sarcomas and lymphomas were only of vimentin type. Furthermore, it was found that the papillary structures in benign goiters were only reactive with cytokeratin antibodies and lacked, in contrast to papillary carcinomas, epidermal prekeratin-like immunoreactivity. Hence, the analysis of intermediate filament proteins of thyroid tumors can be utilized to differentiate between papillary and follicular carcinomas and between benign and malignant papillary lesions as well as between anaplastic thyroid carcinomas and sarcomas or lymphomas.     

Pattern of expression of intermediate cytokeratin filaments in the thyroid gland: an immunohistochemical study of simple and stratified epithelial-type cytokeratins

The expression of simple and stratified epithelial-type cytokeratin (CK) intermediate filaments was evaluated by immunohistochemistry in a series of 41 papillary carcinomas, 10 follicular carcinomas, 2 poorly differentiated carcinomas and 34 specimens of normal thyroid parenchyma and lymphocytic thyroiditis. The aim of the study was to establish the CK profile of normal thyroid and thyroid carcinomas in order to clarify the putative application of CK immunostaining in diagnostic surgical pathology, and to evaluate whether the process of neoplastic transformation and tumour progression in the thyroid may be associated with any particular change in CK expression. Normal thyroid strongly expressed simple epithelial-type CKs 7 and 18 and, to a lesser degree, CKs 8 and 19, but did not express stratified epithelial-type CKs. The same pattern was found in lymphocytic thyroiditis, though the CK 19 immunoreactivity was stronger in these lesions than in the normal thyroid. Papillary and follicular thyroid carcinomas shared the expression of simple epithelial-type CKs 7, 8, 18 and 19. Immunoreactivity for CK 19 was frequently stronger and more widely distributed within each particular tumour in papillary than in follicular carcinomas, but it could also be detected, at least focally, in every follicular carcinoma. Strong expression of CK 19 highlighted small foci of papillary carcinoma not easily identifiable by conventional histological examination. Stratified epithelial-type CKs 5/6 and 13 were detected in a high percentage of papillary carcinomas, in contrast to their absence in follicular carcinomas and normal thyroid. The CK pattern was similar in primary and metastatic papillary carcinomas. We conclude that papillary carcinoma of the thyroid presents a distinct CK profile that may be used for diagnostic purposes.     

Caveolin-1 Expression in Thyroid Neoplasia Spectrum: Comparison of Two Commercial Antibodies

We evaluated caveolin-1 expression in the human thyroid neoplasia spectrum with the aim of examining differences in expression as detected by two anti-caveolin-1 antibodies, and secondly, to investigate the association of caveolin-1 expression levels with aggressive papillary thyroid carcinoma (PTC). Immunohistochemical staining using sc894 or AV09019 antibodies revealed that caveolin-1 was generally overexpressed in the PTC group as a whole (classical and follicular variant) when compared to peritumoral tissue (PT), while it was not detected in about half of follicular thyroid carcinoma (FTC) and majority of follicular adenomas (FTA). Caveolin-1 expression decreased in the following order: clPTC, fvPTC, FTC, PT and FTA. The diagnostic accuracy of AV09019 was better than that of sc894 for discriminating: FTA from FTC, FTA or FTC from the follicular variant of PTC, total PTC from nonmalignant tissue, and malignant tumors from nonmalignant tissue. Spearman''s analysis revealed positive correlations of caveolin-1 expression and extrathyroidal invasion (p < 0.05) in PTC for both antibodies. Additionally, AV09019 antibody correlated caveolin-1 upregulation with pathological T status.To conclude, as an immunohistochemical marker AV09019 antibody performed better than sc894 in distinguishing certain histotypes of thyroid tumors. In addition, increased expression of caveolin-1 may be considered as an indicator of papillary carcinoma progression.     

Galectin-3与CD44v6检测运用于甲状腺癌鉴别诊断中的价值

目的 研究Galectin-3与CD44v6检测在甲状腺癌鉴别诊断中的价值.方法 收集2015年2月至2016年9月我院病理科收集的细针穿刺细胞学标本125例.其中甲状腺癌标本48例,甲状腺良性结节标本41例,另有病变旁正常甲状腺组织36例.分别采用免疫组化法检测不同组织中Galectin-3与CD44v6的表达,并进行对比.此外,比较良恶性甲状腺结节患者的年龄、性别、甲状腺家族史、辐射暴露以及碘摄入情况,并作多因素Logistics回归分析.结果 甲状腺癌组织中Galectin-3与CD44v6的表达阳性率分别为81.25%(39/48)、72.92%(35/48),均高于正常甲状腺组织与甲状腺良性结节,且差异有统计学意义(均P<0.05).良性增生组织中的Galectin-3表达阳性率为0.00%(0/28),低于良性腺瘤组织的15.38%(2/13),且差异有统计学意义(均P<0.05).乳头状癌、髓样癌、滤泡状癌中的Galectin-3与CD44v6表达阳性率均高于低分化或未分化癌,且差异有统计学意义(均P<0.05).恶性甲状腺结节患者的家族史、辐射暴露以及碘摄入过量人数占比均高于对照组,且差异有统计学意义(均P<0.05).经多因素Logistic回归分析发现,甲状腺家族史、辐射暴露以及碘摄入过量均是甲状腺癌危险因素.结论 Galectin-3与CD44v6检测应用于甲状腺癌鉴别诊断的价值较高,有利于区别良性甲状腺结节中的良性增生以及良性腺瘤,同时可有效区别恶性甲状腺结节中的乳头状癌、髓样癌、滤泡状癌以及低分化或未分化癌.     

BRAF mutations are associated with some histological types of papillary thyroid carcinoma

Mutations in the BRAF gene have recently been detected in a wide range of neoplastic lesions with a particularly high prevalence in melanoma and papillary thyroid carcinoma (PTC). The hot-spot mutation BRAF(V599E) is frequently detected in PTC (36-69%), in contrast to its absence in other benign or malignant thyroid lesions. In order to unravel whether there is any association between the occurrence of the BRAF mutation and the histological pattern of PTC, in this study a previous series of 50 PTCs was extended to 134 cases, including ten cases of PTC-related entities-hyalinizing trabecular tumour (HTT) and mucoepidermoid carcinoma (MEC). Using PCR/SSCP and sequencing, the BRAF(V599E) mutation was detected in 45 of the 124 PTCs (36%). No mutations were detected in any case of HTT and MEC. BRAF(V599E) was present in 75% of Warthin-like PTCs and 53% of conventional PTCs, whereas no BRAF(V599E) mutations were detected in any of the 32 cases of the follicular variant of PTC. BRAF(V599E) was also detected in 6 of 11 cases of the oncocytic variant of PTC that displayed a papillary or mixed follicular-papillary growth pattern and in none of the four oncocytic PTCs with a follicular growth pattern. A distinct mutation in BRAF (codon K600E) was detected in three cases of the follicular variant of PTC. This study has confirmed the high prevalence of BRAF(V599E) in PTC and has shown that the mutation is almost exclusively seen in PTC with a papillary or mixed follicular-papillary growth pattern, regardless of the cytological features of the neoplastic cells. The results support the existence of an oncocytic variant of PTC that should be separated from the oncocytic variant of follicular carcinoma and suggest that the follicular variant of PTC may be genetically different from conventional PTC.