THE VALIDITY OF IMMUNOCYTOCHEMISTRY IN DIFFERENTIATING BETWEEN BENIGN AND MALIGNANT THYROID NEOPLASMS PREOPERATIVELY USING FNAC
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 33
Abstract
BACKGROUND Fine Needle Aspiration Cytology (FNAC) of thyroid neoplasms has its own pitfalls when used alone. This study was undertaken to evaluate whether overexpression of galectin-3 can make a presurgical diagnosis of malignant thyroid neoplasms on FNAC (by immunocytochemistry). TTF-1 was also included in the study to identify the thyroid origin of cells. MATERIALS AND METHODS The study sample included patients with solitary thyroid nodules who underwent FNAC and subsequent surgery at our hospital. The study design was based on diagnostic test evaluation. Immunocytochemistry was performed with galectin-3 and TTF-1 on fresh FNA smears by the standard protocol. Grading was done for galectin-3 positivity based on intensity of immunostaining from grade 1 to 3. Postoperative histological diagnosis represented the gold standard. RESULTS 39 solitary thyroid nodules were studied. TTF-1 was positive in 37 out of 39 cases. Galectin-3 was positive in all malignant cases. It showed a sensitivity of 94% and a specificity of 91% in detecting malignancy. Also, grade 3 immunopositivity for Gal-3 was seen only in papillary carcinoma. CONCLUSION Galectin-3 expression is thus a reliable marker of malignancy (particularly in papillary carcinoma) and grading of Gal-3 immunostaining correlates with malignant transformation. The study also reiterates the efficacy of immunocytochemistry on cytological smears.
Authors and Affiliations
Karthika Kundil Veetil, Rajeevan K Nileshwar
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