Galectin-3: presurgical marker of thyroid follicular epithelial cell-derived carcinomas.
Preoperative follicular lesion characterisation represents an unsolved diagnostic problem in thyroid nodular disease. Although fine-needle aspiration biopsy is the most reliable preoperative diagnostic procedure, it shows inherent limitations in differentiating adenoma from follicular carcinoma and, sometimes, follicular variants of papillary carcinoma. Galectin-3 cytoplasmic neoexpression has been proposed as a peculiar feature of thyroid malignant cells, easily detectable in cytological and histological samples. The aim of this study was to re-evaluate the galectin-3 expression in a large sample of thyroid lesions using an immunohistocytochemical biotin-free detection system and a specific anti-human-galectin-3 monoclonal antibody in order to avoid the interference of technical factors, a cause of conflicting results recently reported by some authors. We analysed galectin-3 expression of 39 follicular carcinomas, 26 papillary carcinomas, and 105 adenomas in both cell-block samples and their histological counterparts. All cell-block and histological papillary carcinoma samples showed high levels of galectin-3 immunoreactivity. Thirty-four follicular carcinomas were positive, whereas 5 were negative in cell-blocks but positive in their histological counterparts. Twelve out of 105 adenomas expressed galectin-3 in cell-blocks and histological samples. The diagnostic accuracy of preoperative galectin-3 evaluation in adenomas vs follicular carcinomas was 90.0%. Galectin-3 expression was also investigated in 22 minimally-invasive follicular carcinomas. All of them showed galectin-3 immunoreactivity in both cytological and histological specimens with the exception of two cases, where galectin-3 positivity was observed only in the surgical material. The routine correct use of galectin-3, by increasing the diagnostic accuracy of conventional cytology, improves the management of thyroid nodules and can lead to a sensitive reduction of useless thyroid surgeries.
Saggiorato
E
E
Section of Endocrinology, Department of Clinical and Biological Sciences, University of Turin, Turin, Italy. enrico.saggiorato@unito.it
Aversa
S
S
Deandreis
D
D
Arecco
F
F
Mussa
A
A
Puligheddu
B
B
Cappia
S
S
Conticello
S
S
Papotti
M
M
Orlandi
F
F
D018263:Adenocarcinoma, Follicular / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D000236:Adenoma / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology; D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor / Q000032:analysis*; D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology; D002467:Cell Nucleus / Q000737:chemistry; D003593:Cytoplasm / Q000737:chemistry; D003937:Diagnosis, Differential; D037502:Galectin 3 / Q000032:analysis*; D006801:Humans; D007150:Immunohistochemistry; D011300:Preoperative Care; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D016606:Thyroid Nodule / Q000473:pathology / Q000601:surgery*
D000911:Antibodies, Monoclonal; D014408:Biomarkers, Tumor; D037502:Galectin 3