Thyroid carcinomas are classically diagnosed based on specific morphological criteria. In some cases, a definitive diagnosis may be difficult when morphological features are equivocal. This study evaluated the utility of Hector Battifora Mesothelial-1 (HBME-1) as an immunohistochemical marker to differentiate malignant from benign thyroid lesions and to compare its expression in different types of thyroid lesions. The sensitivity and specificity of HBME-1 as a specific marker for thyroid carcinoma were also studied. A total of 54 malignant and 54 benign thyroid cases diagnosed were collected in Universiti Kebangsaan Malaysia Medical Centre for a period of seven years. All cases were stained with HBME-1 and evaluated by three independent observers. The cases were scored based on the proportion of staining and graded as 0 (less than 10%), 1+ (10-25%), 2+ (26-50%) or 3+ (more than 50%). In addition, the score of malignant cases was correlated with their pathological tumour stage. HBME-1 showed significantly higher expression in malignant compared to benign lesions (P<0.001) with papillary thyroid carcinoma (PTC) showed the highest expression among the carcinoma cases (87.1%). Benign lesions were mostly negative (96%), except for two follicular adenoma cases having focal positivity. HBME-1 had a sensitivity of 57% and specificity of 96% in thyroid carcinoma. There was no correlation between HBME-1 expression and TNM primary tumour stage (pT). HBME-1 might be a useful marker in distinguishing malignant from benign thyroid lesions, especially in PTC cases.
HBME-1 Expression in Differentiating Benign and Malignant Thyroid Lesions
Author
Abstrak
Karsinoma tiroid biasanya didiagnoskan berdasarkan kriteria morfologi tertentu. Dalam sesetengah kes, diagnosis yang tepat mungkin sukar apabila ciri-ciri morfologi adalah tidak ketara. Kajian ini menilai kegunaan Hector Battifora Mesothelial-1 (HBME-1) sebagai penanda immunohistokimia untuk membezakan tisu tiroid barah dengan bukan barah dan untuk membandingkan ekspresi HBME-1 dalam pelbagai jenis tisu tiroid. Sensitiviti dan spesifisiti HBME-1 sebagai penanda khusus untuk karsinoma tiroid juga dikaji. Sejumlah 54 kes barah dan 54 kes bukan barah tiroid yang didiagnos di Pusat Perubatan Universiti Kebangsaan Malaysia untuk tempoh tujuh tahun telah dikumpul. Semua kes diwarnai dengan HBME-1 dan dinilai oleh tiga pemerhati bebas. Kes-kes tersebut diberi skor berdasarkan nisbah pewarnaan dan dinilai sebagai skor 0 (kurang daripada 10%), 1+ (10-25%), 2+ (26-50%) atau 3+ (lebih daripada 50%). Di samping itu, perkaitan antara skor bagi kes barah dengan peringkat patologi tumor juga dikaji. HBME-1 menunjukkan ungkapan pewarnaan yang lebih signifikan dalam kes barah berbanding bukan barah (P<0.001) dengan karsinoma tiroid papilari menunjukkan ungkapan tertinggi di kalangan kes karsinoma (87.1%). Kes bukan barah kebanyakannya adalah negatif (96%), kecuali dua kes adenoma folikular yang menunjukkan skor 1+. HBME-1 mempunyai sensitiviti sebanyak 57% dan spesifisiti setinggi 96% bagi karsinoma tiroid. Tiada perkaitan antara ekspresi HBME-1 dengan peringkat patologi tumor berdasarkan klasifikasi TNM (pT). Kesimpulannya, HBME-1 berkemungkinan boleh menjadi penanda yang berguna dalam membezakan kes tiroid barah daripada bukan barah, terutamanya dalam kes-kes karsinoma tiroid papilari.
Kata kunci
Abstract
|
|
|
