title: Follicular thyroid neoplasms can be classified as low- and high-risk according to HBME-1 and Galectin-3 expression on liquid-based fine-needle cytology.
abstract: METHODS
  Fine-needle aspiration biopsy (FNAB) is the most reliable diagnostic tool in the diagnosis of thyroid nodules. A cytologic diagnosis of follicular neoplasm with atypical cells of undetermined significance (FN/AUS) implies that the selection of patients between surgery and follow-up is difficult. In this setting immunocytochemical stainings might be helpful. The efficacy of a panel made up of HBME-1 and Galectin-3 antibodies is evaluated in cases processed by liquid-based cytology (LBC).
  
  
  METHODS
  Out of 7091 thyroid FNAB processed by LBC method, 120 cases undergoing surgery successively were selected. These cases were classified as benign lesion (BL, eight cases), FN, including the ACUS category of the Bethesda classification (FN/AUS, 50 cases), suspicious for malignancy (SM, 59 cases), and malignant neoplasm (MN, three cases). Immunostains for HBME-1 and Galectin-3 were carried out on the LBC slides.
  
  
  RESULTS
  All MN and BL were histologically confirmed. FN/AUS and SM showed a malignancy risk of 24 and 72.9% respectively. The complete immunocytochemical panel was positive in 83.3% of the cases resulting in malignancy and negative in 87.5% of cases resulting in benign histology. Among the FN/AUS, the complete positive immunocytochemical panel was detected in 76.9% of cases resulting as malignant and the complete negative immunocytochemical panel was observed in 96.8% of cases resulting as benign at histology.
  
  
  CONCLUSIONS
  The expression of HBME-1 and Galectin-3 in cases classified as FN/AUS on LBC-processed FNABs can effectively distinguish lesions, which need immediate surgery (high risk or FNH or Thy 3h) from those which can be followed-up (low risk or FNL or Thy 3l).
authors: Divisions of Anatomic Pathology and Histology Endocrinology Endocrine Surgery, Agostino Gemelli School of Medicine, Catholic University of Sacred Heart, Largo Francesco Vito, 1 - 00168 Rome, Italy. guidofadda@rm.unicatt.it
authors: Guido
authors: G
authors: Fadda
authors: Esther Diana
authors: ED
authors: Rossi
authors: Marco
authors: M
authors: Raffaelli
authors: Alfredo
authors: A
authors: Pontecorvi
authors: Stefano
authors: S
authors: Sioletic
authors: Francesca
authors: F
authors: Morassi
authors: Celestino Pio
authors: CP
authors: Lombardi
authors: Gian Franco
authors: GF
authors: Zannoni
authors: Guido
authors: G
authors: Rindi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis / Q000276:immunology*; D044963:Biopsy, Fine-Needle / Q000379:methods; D003581:Cytodiagnosis; D005260:Female; D037502:Galectin 3 / Q000032:analysis / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods; D013964:Thyroid Neoplasms / Q000145:classification / Q000276:immunology / Q000473:pathology*; D016606:Thyroid Nodule / Q000473:pathology; D000951:Antigens, Neoplasm
chemical_list: D014408:Biomarkers, Tumor; D037502:Galectin 3; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm