CXC chemokine receptor 4 immunodetection in the follicular variant of papillary thyroid carcinoma: comparison to galectin-3 and hector battifora mesothelial cell-1.
BACKGROUND
The cytological discrimination between benign and malignant follicular-patterned lesions of the thyroid can represent a diagnostic challenge, even for experienced pathologists. We evaluated the diagnostic use of protein expression of CXC chemokine receptor 4 (CXCR4) and galectin-3 (gal-3) that were found to be upregulated in papillary thyroid carcinoma compared to normal thyroid and of mesothelial cell surface protein recognized by monoclonal antibody Hector Battifora Mesothelial cell (HBME)-1 in thyroid tumors.


METHODS
Expression of CXCR4, HBME-1, and gal-3 was examined immunohistochemically in total of 100 aspirates of thyroid lesions, categorized as benign (n = 22), indeterminate lesion (n = 43), suspicious of papillary thyroid carcinoma (n = 10), or malignant (n = 25) by preoperative cytology.


RESULTS
Expression of each individual marker was significantly associated with malignancy (p < 0.0001), although the sensitivity of detection ranged from 56% for gal-3 to 94% for HBME-1. When focusing on the indeterminate lesions, only CXCR4 and HBME-1 expression was associated with malignancy; moreover, these two markers either used individually or in combination showed good values of diagnostic accuracy (88.4% and 90.7%, respectively). Further, the combination of CXCR4 plus HBME-1 or the simultaneous use of all the three markers provided absolute value of sensitivity and negative predictive value in the same group of lesions.


CONCLUSIONS
An immunohistochemical panel, including CXCR4, could be useful in the differential diagnosis between benign and malignant well-differentiated follicular-patterned thyroid lesions.
Torregrossa
Liborio
L
Division of Pathology, Department of Surgery, University of Pisa , Pisa, Italy.
Faviana
Pinuccia
P
Filice
Maria Elena
ME
Materazzi
Gabriele
G
Miccoli
Paolo
P
Vitti
Paolo
P
Fontanini
Gabriella
G
Melillo
Rosa Marina
RM
Santoro
Massimo
M
Basolo
Fulvio
F
D014408:Biomarkers, Tumor / Q000737:chemistry* / Q000235:genetics; D044963:Biopsy, Fine-Needle; D018265:Carcinoma, Papillary, Follicular / Q000737:chemistry* / Q000235:genetics / Q000473:pathology; D037502:Galectin 3 / Q000737:chemistry* / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D019718:Receptors, CXCR4 / Q000737:chemistry* / Q000235:genetics; D013964:Thyroid Neoplasms / Q000235:genetics* / Q000473:pathology; D016606:Thyroid Nodule / Q000473:pathology / Q000601:surgery; D000951:Antigens, Neoplasm
D014408:Biomarkers, Tumor; D037502:Galectin 3; D019718:Receptors, CXCR4; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm