title: Combined staining for immunohistochemical markers in the diagnosis of papillary thyroid carcinoma: improvement in the sensitivity or specificity?
abstract: OBJECTIVE
  To investigate the ability of cytokeratin (CK)-19, galectin-3, human bone marrow endothelial cell (HBME)-1 and tyrosine kinase-type cell surface receptor HER2 (HER-2/neu) to differentiate papillary thyroid carcinoma (PTC) from benign thyroid nodules.
  
  
  METHODS
  Archival specimens of PTC and benign thyroid nodules were included in this retrospective immunohistochemical study. CK-19, galectin-3, HBME-1, and HER-2/neu protein levels were analysed immunohistochemically using routinely prepared tissue sections.
  
  
  RESULTS
  Specimens from 331 patients with PTC and 664 patients with benign thyroid nodules were reviewed. For all four protein markers, the percentage of samples with cells that demonstrated positive immunostaining was significantly higher in PTC specimens than in benign thyroid nodules. As a single protein marker, CK-19 was the most sensitive (92.7%) and HBME-1 was the most specific (97.9%). The combination of CK-19 and galectin-3 was the most sensitive (82.8%), and the combinations of HBME-1 with CK-19 or galectin-3 or HER-2/neu were the most specific (98.3%).
  
  
  CONCLUSIONS
  The combination of HBME-1 and either CK19 or galectin-3 or HER-2/neu can improve the specificity of the diagnosis of PTC.
authors.affiliation: Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Wu
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
authors.forename: Zhongwen
authors.initials: Z
authors.lastname: Zhou
authors.forename: Tianyi
authors.initials: T
authors.lastname: Li
authors.forename: Feng
authors.initials: F
authors.lastname: Tang
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000235:genetics*; D001798:Blood Proteins; D002277:Carcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D002291:Carcinoma, Papillary; D005260:Female; D037502:Galectin 3 / Q000235:genetics*; D037161:Galectins; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D053539:Keratin-19 / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D016606:Thyroid Nodule / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology; D000951:Antigens, Neoplasm
chemical_list: D014408:Biomarkers, Tumor; D001798:Blood Proteins; D037502:Galectin 3; D037161:Galectins; D053539:Keratin-19; D018719:Erb-b2 Receptor Tyrosine Kinases; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm; C428445:LGALS3 protein, human; C508053:ERBB2 protein, human
keywords: Papillary thyroid carcinoma; cytokeratin-19; galectin-3; human bone marrow endothelial cell-1; tyrosine kinase-type cell surface receptor HER2