Combined analysis of galectin-3 and BRAFV600E improves the accuracy of fine-needle aspiration biopsy with cytological findings suspicious for papillary thyroid carcinoma.
Ten to fifteen percent of fine-needle aspiration biopsy (FNAB) of thyroid nodules are indeterminate. Galectin-3 (Gal-3) and the oncogene BRAFV600E are markers of malignancy useful to improve FNAB accuracy. The objective of this study was to determine whether the combined analysis of Gal-3 and BRAFV600E expression in thyroid aspirates could improve the diagnosis in FNAB with suspicious cytological findings. Two hundred and sixty-one surgical thyroid tissues and one hundred and forty-four thyroid aspirates were analyzed for the presence of the two markers. In surgical specimens, Gal-3 expression was present in 27.4% benign nodules, 91.9% papillary (PTC) and 75% follicular (FTC) thyroid carcinomas. BRAFV600E was not detected in 127 benign nodules, as well as in 32 FTCs, while was found in 42.9% PTC. No correlation was found between BRAF mutation and Gal-3 expression. Forty-seven consecutive FNAB suspicious for PTC were analyzed for the presence of the two markers. Of these nodules, 23 were benign at histology, 6 were positive for Gal-3, none displayed BRAFV600E, and 17 were negative for both the markers. Twenty suspicious nodules were diagnosed as PTC and four FTCs at histology. Of these 24 carcinomas, 9 resulted positive for BRAFV600E, 17 for Gal-3, and 22 for one or both the markers. The sensitivity, specificity, and accuracy for the presence of Gal-3 and/or BRAFV600E were significantly higher than those obtained for the two markers alone. Notably, the negative predictive value increased from 70.8 to 89.5%. In conclusion, the combined detection of Gal-3 and BRAFV600E improves the diagnosis in FNAB with cytological findings suspicious for PTC and finds clinical application in selected cases.
Sapio
Maria Rosaria
MR
Department of Endocrinologia ed Oncologia Molecolare e Clinica, Università Federico II, Via S. Panini, 5, Naples 80131 Italy.
Guerra
Anna
A
Posca
Daniela
D
Limone
Paolo Piero
PP
Deandrea
Maurilio
M
Motta
Manuela
M
Troncone
Giancarlo
G
Caleo
Alessia
A
Vallefuoco
Pasquale
P
Rossi
Guido
G
Fenzi
Gianfranco
G
Vitale
Mario
M
D000225:Adenine; D000231:Adenocarcinoma, Papillary / Q000235:genetics* / Q000473:pathology*; D019943:Amino Acid Substitution; D044963:Biopsy, Fine-Needle; D037502:Galectin 3 / Q000235:genetics*; D006801:Humans; D020641:Polymorphism, Single Nucleotide; D011237:Predictive Value of Tests; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D012680:Sensitivity and Specificity; D013941:Thymine; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000473:pathology*
D037502:Galectin 3; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf; D000225:Adenine; D013941:Thymine