title: Application of chemokine CXC motif ligand 12 as a novel diagnostic marker in preoperative fine-needle aspiration biopsy for papillary thyroid carcinoma.
abstract: OBJECTIVE
  A panel composed of three immunomarkers, cytokeratin 19, HBME-1 and galectin-3, is recommended for improving the accuracy of diagnosing papillary thyroid carcinoma (PTC), but the results are sometimes inconsistent and difficult to interpret. We used immunocytochemistry to assess the utility of chemokine CXC ligand 12 (CXCL12) as a novel diagnostic marker for PTC employing paraffin-embedded cell blocks.
  
  
  METHODS
  We analyzed the expression of CXCL12 using immunocytochemical staining in 82 cases of thyroid lesions (47 PTCs and 35 thyroid lesions other than PTC). To determine the optimal cut-off value for the assessment of CXCL12 positivity, we used receiver operating characteristics (ROC).
  
  
  RESULTS
  ROC curves showed that the optimum diagnostic cut-off was 10% (area under the curve 0.950, 95% confidence interval 0.891-1.008), with exclusive CXCL12 expression in PTC compared to other thyroid lesions (p < 0.001). In total, more than 90% of the PTCs were associated with CXCL12 immunohistochemical staining, while only up to 11.4% of thyroid lesions other than PTC were positive for CXCL12. The follicular variant PTC showed 90% CXCL12 expression compared to 10.5% positivity in follicular neoplasm.
  
  
  CONCLUSIONS
  Our findings indicate that CXCL12 may be an effective supplementary diagnostic marker for PTC in preoperative fine-needle aspiration cytology using the cell block method.
authors.affiliation: Department of Pathology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, South Korea.
authors.forename: Yoon Yang
authors.initials: YY
authors.lastname: Jung
authors.forename: In Ae
authors.initials: IA
authors.lastname: Park
authors.forename: Min A
authors.initials: MA
authors.lastname: Kim
authors.forename: Hye Sook
authors.initials: HS
authors.lastname: Min
authors.forename: Jae Kyung
authors.initials: JK
authors.lastname: Won
authors.forename: Han Suk
authors.initials: HS
authors.lastname: Ryu
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology; D002291:Carcinoma, Papillary; D018265:Carcinoma, Papillary, Follicular / Q000175:diagnosis / Q000473:pathology; D054377:Chemokine CXCL12 / Q000378:metabolism; D003581:Cytodiagnosis; D005260:Female; D037502:Galectin 3; D006801:Humans; D007150:Immunohistochemistry; D053539:Keratin-19; D008297:Male; D012372:ROC Curve; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; C515255:CXCL12 protein, human; D054377:Chemokine CXCL12; D037502:Galectin 3; D053539:Keratin-19