title: Diagnostic usefulness of HBME1, galectin-3, CK19, and CITED1 and evaluation of their expression in encapsulated lesions with questionable features of papillary thyroid carcinoma.
abstract: We evaluated HBME1, galectin-3 (GAL3), cytokeratin (CK)19, and a new anti-CITED1 antibody in 127 follicular adenoma (FA) and papillary thyroid carcinoma (PTC) cases. The findings were used to evaluate 11 diagnostically challenging encapsulated follicular lesions with questionable features of PTC (FL/QPTC). All 4 markers showed higher expression in PTC than FA. HBME1 was the most specific (96%), whereas CK19 was the most sensitive (96%). In addition, 100% specificity was seen with coexpression of HBME1/CK19. Negative expression of all 4 markers was 97% specific for FA. GAL3 and CITED1, less useful individually, could help in selective cases. FL/QPTC showed heterogeneous, often intermediate, staining patterns, implying that some FL/QPTCs may be biologically borderline lesions or represent a biologic spectrum of PTC. These antibodies can have a confirmatory role in distinguishing the follicular variant of PTC and FA. For FL/QPTC, these antibodies are helpful in some cases, their limitation perhaps suggesting the biologic ambiguity of these lesions.
authors.affiliation: Department of Pathology and Laboratory Medicine, Weill Medical College of Cornell University, New York, NY 10021, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Scognamiglio
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hyjek
authors.forename: Jean
authors.initials: J
authors.lastname: Kao
authors.forename: Yao-Tseng
authors.initials: YT
authors.lastname: Chen
mesh_terms: D000231:Adenocarcinoma, Papillary / Q000175:diagnosis* / Q000378:metabolism; D000236:Adenoma / Q000175:diagnosis* / Q000378:metabolism; D051017:Apoptosis Regulatory Proteins; D014408:Biomarkers, Tumor / Q000032:analysis*; D003937:Diagnosis, Differential; D005260:Female; D037502:Galectin 3 / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D053539:Keratin-19 / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000032:analysis; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D015534:Trans-Activators; D014157:Transcription Factors / Q000032:analysis; D000951:Antigens, Neoplasm
chemical_list: D051017:Apoptosis Regulatory Proteins; D014408:Biomarkers, Tumor; D037502:Galectin 3; D053539:Keratin-19; D009687:Nuclear Proteins; D015534:Trans-Activators; D014157:Transcription Factors; C512688:CITED1 protein, human; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm