Thyroid nodule management depends mainly on fine needle aspiration cytology to bear out its nature. Yet, in particular cases, differentiation between benign and malignant thyroid nodules represents a diagnostic problem. Our aim was to investigate the diagnostic utility of cyclinD1, galactin3, and CK19 immunostains in resolving this issue, as the financial and emotional load of malignancy management is particularly considerable.
Our study included 60 patients presented with nodular thyroid enlargement. After surgery, 30 cases were diagnosed histologically as follicular adenomas and 30 cases were diagnosed as papillary thyroid carcinomas. Immunohistochemical study of the aforementioned markers was performed in both groups. The best cut-off level and the diagnostic performance of single or combinations of these immunohistochemical markers were calculated by using the receiver operating characteristic curve analysis.
Signal intensities for galactin3, CK19, and cyclinD1 were significantly greater in papillary thyroid carcinoma compared with follicular adenomas. The combination of K19/cyclinD1 exhibited the highest performance to assess the diagnosis of malignancy with overall diagnostic accuracy was 99.2%, with 90.3% sensitivity, 100% specificity, 100% positive predictive value, and 90.8% negative predictive value.
Our findings advocate that a combination of K19/cyclinD1 markers may increase the reliability of identification of thyroid malignancy. We recommend more studies on cyclinD1 expression in wider thyroid lesions and more precise statistical results with a higher number of cases.
aDepartment of Pathology, Banha University, Banha
bDepartment of pathology, Assiut University, Assiut, Egypt
Correspondence to Shaimaa K. Dawa, MD, Department of Pathology, Faculty of Medicine, Banha University, Banha, Egypt Tel: +20 9665 3740 3741; e-mail: firstname.lastname@example.org
Received October 28, 2017
Accepted November 13, 2017