title: Role of cd56 and e-cadherin expression in the differential diagnosis of papillary thyroid carcinoma and suspected follicular-patterned lesions of the thyroid: the prognostic importance of e-cadherin.
abstract: BACKGROUND
  The pathological diagnosis of papillary thyroid carcinoma (PTC) is generally easy on routine sections stained with hematoxylin and eosin (H&E). However, the differentiation of the follicular variant of PTC (FVPTC) from other suspected follicular-patterned lesions of the thyroid is highly difficult. Among these, the lesions for which FVPTC cannot be excluded are classified as well-differentiated tumors of uncertain malignant potential (WDT-UMP). The most common immunohistochemical (IHC) markers used in the differential diagnosis include HBME-1, galectin-3, and CK19. However, none of these markers provide a 100% differential diagnosis.
  
  
  OBJECTIVE
  The present study compared the diagnostic value of CD56 and E-cadherin for the differentiation of FVPTC from the other benign follicular-patterned lesions, with HBME-1, galectin-3, and CK19. Using these markers, the controversial cases within the WDT-UMP group were reclassified. Additionally, the relationship between the reductions in E-cadherin expression with poor prognostic factors was investigated.
  
  
  METHODS
  The IHC expressions of CD56, E-cadherin, HBME-1, galectin-3, and CK19 were evaluated in 181 thyroid lesions, including 101 PTCs (45 classical variant PTCs and 56 FVPTCs), 20 WDT-UMPs, 20 follicular adenomas (FAs), 20 hyperplastic nodules (HN), and 20 hyperplastic foci of lymphocytic thyroiditis. The results were statistically compared via SPSS.
  
  
  RESULTS
  The expressions of all of the markers were statistically significantly different in PTC and follicular-patterned lesions (P<0.05). It was found that the only marker with both sensitivity and specificity above 90% was CD56 negativity (sensitivity 91.1%, specificity 91.7%). The most sensitive and also the most specific double panel was CD56 negativity and galectin-3 positivity (sensitivity 96%, specificity 85%), and the most sensitive and specific triple panel was CD56 negativity, HBME-1 positivity, and galectin-3 positivity (97% and 70%, respectively).
authors.affiliation: Department of Pathology, Istanbul Medeniyet University Göztepe Research and Training Hospital Turkey.
authors.forename: Ayşe Bahar
authors.initials: AB
authors.lastname: Ceyran
authors.affiliation: Department of Pathology, Istanbul Medeniyet University Göztepe Research and Training Hospital Turkey.
authors.forename: Serkan
authors.initials: S
authors.lastname: Şenol
authors.affiliation: Department of Pathology, Istanbul Medeniyet University Göztepe Research and Training Hospital Turkey.
authors.forename: Bengü Çobanoğlu
authors.initials: BÇ
authors.lastname: Şimşek
authors.affiliation: Department of General Surgery, Istanbul Medeniyet University Göztepe Research and Training Hospital Turkey.
authors.forename: Julide
authors.initials: J
authors.lastname: Sağıroğlu
authors.affiliation: Department of Pathology, Istanbul Medeniyet University Göztepe Research and Training Hospital Turkey.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Aydın
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism; D019002:CD56 Antigen / Q000378:metabolism*; D015820:Cadherins / Q000378:metabolism*; D002291:Carcinoma, Papillary / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D037502:Galectin 3 / Q000378:metabolism; D006801:Humans; D053539:Keratin-19 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D013961:Thyroid Gland / Q000378:metabolism* / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D055815:Young Adult; D000951:Antigens, Neoplasm
chemical_list: D014408:Biomarkers, Tumor; D019002:CD56 Antigen; D015820:Cadherins; D037502:Galectin 3; D053539:Keratin-19; C432845:HBME-1 antigen; D000951:Antigens, Neoplasm; C522918:NCAM1 protein, human
keywords: CD56; E-cadherin; HBME-1; follicular-patterned lesions; galectin-3; thyroid papillary cancer