[TPO immunostaining of the solitary, cold thyroid nodules].
BACKGROUND
The chance of malignancy in scintigraphically cold thyroid nodules is 2-24%. Differentiation between malignant and benign cytology is difficult. The aim of this study was to evaluate the ability of immunostaining (MoAB47--raised against thyroid peroxidase (TPO)) to differentiate between malignant and benign cells taken from cold thyroid nodules by fine needle aspiration biopsy (FNAB) in order to reduce the number of unnecessary thyroid operations.


METHODS
One hundred and eighty-one patients (150 female) with a scintigraphically cold, solitary thyroid nodule were entered between 1993 and 1996. Fifty-seven were excluded for various reasons. Material removed by FNAB was stained with MoAB47 and routine staining. Staining of 80% or more of the cells was considered benign, less than 80% was considered malignant. Routine staining of operatively removed material was used as the final diagnosis.


RESULTS
A pattern with negative TPO staining was found in all lesions that were subsequently proved to be malignant. In all but one, the lesions subsequently diagnosed as being benign stained positive for TPO. The sensitivity and specificity were respectively 1.0 and 0.99.


CONCLUSIONS
TPO immunostaining of material removed by FNAB is a powerful tool in the differentiation between benign and malignant tumours.
Lange
M
M
H:S Rigshospitalet, medicinsk endokrinologisk klinik, København.
Blichert-Toft
M
M
Christensen
L H
LH
Brandt
M
M
Sneppen
S B
SB
Ravnsbaek
J
J
Mollerup
C L
CL
Strange
L
L
Jensen
F
F
Kirkegaard
J
J
Hansen
H S
HS
Sørensen
S S
SS
Feldt-Rasmussen
U F
UF
D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D007453:Iodide Peroxidase / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013194:Staining and Labeling / Q000379:methods*; D016606:Thyroid Nodule / Q000000981:diagnostic imaging / Q000276:immunology* / Q000473:pathology
D007453:Iodide Peroxidase
TPO-immunfarvning af den solitaere, kolde thyreoideaknude.