title: Utility of malignancy markers in fine-needle aspiration cytology of thyroid nodules: comparison of Hector Battifora mesothelial antigen-1, thyroid peroxidase and dipeptidyl aminopeptidase IV.
abstract: The purpose of this study was to compare the diagnostic interest of Hector Battifora mesothelial antigen-1 (HBME-1), thyroid peroxidase (TPO), and dipeptidyl aminopeptidase IV (DPP4) in thyroid fine-needle aspirates obtained from 200 resected thyroid lesions (55 colloid nodules, 54 follicular adenomas, 59 papillary cancers, and 32 follicular carcinomas). Hector Battifora mesothelial antigen-1 or TPO expression (% positive cells) and DPP4 staining score (12-point scale) were evaluated. Receiver operating characteristic (ROC) curves were plotted and optimal cutoff values for diagnosing malignancy were determined. The TPO ROC curve was consistently higher than the HBME-1 ROC curve. The TPO curve was also higher than the DPP4 curve with regard to sensitivity, but dipped below the DPP4 curve with regard to specificity. Using a cutoff value of <80% positive cells for TPO, >10% positive cells for HBME-1, and staining score > or =1 for DPP4, sensitivity to specificity ratios were 98-83% for TPO, 90-60% for HBME-1, and 88-80% for DPP4. Two particularly interesting findings of this study were the low negative likelihood ratio of TPO (0.02) allowing highly reliable exclusion of malignancy and the 100% specificity of DPP4 staining scores=12. Due to poor performance on follicular lesions, HBME-1 showed no advantage over TPO or DPP4.
authors.affiliation: Laboratoire d'Anatomie et de Cytologie Pathologique, Faculté de Médecine, Bd Pierre Dramard, 13916 Marseille Cedex 20, France. catherine.demicco@ap-hm.fr
authors.forename: C
authors.initials: C
authors.lastname: de Micco
authors.forename: V
authors.initials: V
authors.lastname: Savchenko
authors.forename: R
authors.initials: R
authors.lastname: Giorgi
authors.forename: F
authors.initials: F
authors.lastname: Sebag
authors.forename: J-F
authors.initials: JF
authors.lastname: Henry
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000175:diagnosis / Q000378:metabolism*; D001324:Autoantigens / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism*; D044963:Biopsy, Fine-Needle; D001707:Biopsy, Needle; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000378:metabolism*; D003581:Cytodiagnosis; D018819:Dipeptidyl Peptidase 4 / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D007453:Iodide Peroxidase / Q000378:metabolism*; D033862:Iron-Binding Proteins / Q000378:metabolism*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D016606:Thyroid Nodule / Q000378:metabolism / Q000473:pathology; D000951:Antigens, Neoplasm
chemical_list: D001324:Autoantigens; D014408:Biomarkers, Tumor; D018819:Dipeptidyl Peptidase 4; D007453:Iodide Peroxidase; D033862:Iron-Binding Proteins; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm; C056658:TPO protein, human; C042807:DPP4 protein, human